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Full text of "The Canadian Nurse Volume 63"


Lnuary 1967 


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habilitation 
of thalidomide 
children 
needed: income 
tax revisions 
varicosities 
and management 


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Niacinamide . 1,250 mg. 
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USUALLY: 
1 One requisition 
goes to Central 
Supply for D5W 


3 USjJally nurse 
must procure a 
syringe and needle 


5 Materials go to 
nursing slat ion. 
and are checked 


2 Another copy goes 
to pharmacist lor 
I.V. vitamins 


4 Each added 
requisition also 
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7 She withdraws 9 She re-Iabels 
concentrate by botlle to show 
syringe correct contents 
8 Using sterile 10 Only now has she 
procedure, she caught up with 
enters liter botlle Surbex-1000 
Solution 


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2 THE CANADIAN NURSE 


1435 St. Alexander St., 
Montreal, Que. 


JANUARY 196: 



The 
Canadian 
Nurse 


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A monthly journal for the nurses of Canada published 
in English and French editions by the Canadian Nurses' Association 


Volume 63, Number 1 


January 1967 


26 Habilitation of Thalidomide Children: 
The Nursing Approach M. O'Brien, M. Owens, and J. Ralph 
29 Impact of Cerebral Palsy on Patient 
and Family W.A. Hawke 
P. Grondin and C. Meere 


32 Recent Advances in Heart Surgery 
36 Intensive Care Unit in Cardiovascular 
Surgery 
39 Varicose Veins of the Lower Limb 
43 
45 


50 


Nursing Care in Varicose Vein Surgery 
Effectiveness of Nursing Visits 
to Primigravida Mothers 
Project Bed Rest 


C. Boisvert 
P. Dionne 
M. Rodrigue 


L.S. Brown 


L. Dahl, M. Smith, B. Fowle 
1. Hutchison, R. Graham, and D. Black 


The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 


4 Letters 
7 News 
16 Names 
22 New Products 
23 Dates 


25 Editorial 
53 Books 
55 Films 
56 Accession List 
1966 Index 
II Official Directory 


Executive Director: Helen K. Mussallem . 
Editor: VIrginia A. Llndabury . Assistant 
Editor: Glennls N. Zilm . News Editor: June 
I. Ferguson . Editorial Assistant: Carla D. 
Penn . Circulation Manager: Plerrette Hotte . 
Advertising Manager: Ruth H. Baumel. Sub- 
scription Rates: Canada: One Year. $4.50; two 
years, $8.00. Foreign: One Year, $5.00; two 
years. $9.00. Single copies: SO cents each. 
Make cheques or money orders payable to 
The Canadian Nurse . Change of Address: 
Four weeks' notice and the old address as 
v.: ell as t
e new are necessary. Not respon- 
sIble for Journals lost in mail due to errors 
in address. 


Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. Alt 
manuscripts should be typed, double-spaced. 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial chan
es. 
Photo
raphs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate defimte dates of publication. 
Authorized as Second-Class Mail bv the Post 
Office Department, Ottawa, and for_payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. SO The Driveway, 
Ottawa 4, Ontario. 
@ Canadian Nurses' Association, 1966 


An item appearing recently in 
a French-language newspaper 
reports that married women in 
Sweden are seriously questioning 
whether it is worth their while to 
seek gainful employment. 
Apparently income taxes are in- 
creased disproportionately when 
more than one member of the 
family brings home a paycheck. 
Moreover, the Swedish women 
complain that child care costs, a 
necessary expense for working 
mothers with young children, 
cannot be deducted from income 
tax. 
Similar deterrents to employment 
of married women are found in 
Canada. The income tax structure 
was organized at a time when the 
man in the home was the sole 
breadwinner, and has not been 
revised to keep apace of the 
changing role of women in 
the economy. 
After examining present income 
tax policy as it pertains to married 
women, we became convinced that 
its irrelevancies could be discussed 
adequately only in a full page 
editorial (page 25). 
We believe that a revised Income 
Tax Act that recognizes the role 
of married women in the labor 
force will benefit the country's 
economy as well as individuals and 
their families. We realize, also, 
that taxation procedures inflict 
hardships on many different groups 
within the labor force. In this 
article we are dealing primarily 
with married women who are 
nurses, because we believe that 
anything that inhibits the re-entry 
of professional nurses into a 
practice already short of practition- 
ers is detrimental to Canadian 
health services and to Canada. 
- Editor. 
THE CANADIAN NURSE 3 


JANUARY 1967 



letters 


{ 


Letters to the editor are welcome. 
Only signed letters will be considered for publication 
Name will be withheld at the writer's request. 


Nurgentsl 
Dear Editor: 
I was delighted to read in your October 
issue that male nurses are likely to be wel- 
comed into the study and work of obstetrical 
nursing. 
Seventy years ago I started my nursing 
career in the Samaritan Hospital for Women 
in Glasgow, Scotland and I learned a lot 
that was good to know about women and 
also men. Very soon I felt angry that male 
nurses in military hospitals were called 
"orderlies." I know how kind men can be 
and, even with their extra strength, how 
gently they can handle patients - often 
better than women. Has anyone thought 
of calling them "nurgents?" With every good 
wish for your magazine. - Jean McMartine 
Weir, B.C. 


Dear Editor: 
We were interested to read the article 
"Why not obstetric nursing for male stu- 
dents?" (October 1966.) 
As we are men in nursing, we are pleased 
to see articles such as this appearing in 
the magazine. We were surprised to learn 
that only an estimated 60 percent of male 
nurses have had obstetrical nursing exper- 
ience. We agree that the rationale for this, 
"that the obstetrical patient would be embar- 
rassed if a male nurse attended to her nurs- 
ing care needs" is not sound. We wonder 
how these schools reason that women who 
have had male nurses attending to them in 
the case room, would be more embarrassed 
in tbe postpartum period. 
There are six men enrolled in the nursing 
course at the Regina Grey Nuns' School of 
Nursing, Regina, Saskatchewan. Two are 
presently in obstetrical nursing. It is man- 
datory that we take the full obstetric course, 
theory and practice. 
We perform total nursing care - anti- 
and postpartum, with the exception of peri- 
neal care. We will also be having the reg- 
ular experience in the case room, nursery 
and premature nursery. 
We have exprienced complete acceptance 
by the mothers and the present ward staff. 
We are convinced that all schools of nurs- 
ing should attempt to prepare aU their stu- 
dents, male or female, to be fully qualified 
with a basic understanding in all nursing 
areas. - Dave Hunter, R.P.N., and Bill 
Ayotte, R.P.N., senior nursing students, 
Regina Grey Nuns' School of Nursing, 


Reciprocity wanted 
Dear Editor: 
We are concerned with the provincial 
4 THE CANADIAN NURSE 


and international re-registration of nurses. 
It seems to us that pettiness and nastiness 
abound. How about action on international 
registration ? 
We are all members of the International 
Council of Nurses, and each delegate is 
recognized as a professional nurse. Is it not 
odd that we should find such difficulty in 
accepting each other outside Geneva? 
We suggest a blitz here and now: All 
Canadian nurses should apply for registra- 
tion in at least one other province and one 
other country. This action would give the 
individual nurse experience with this pro- 
blem; she would also discover that nurses 
around the world are more alike than dif- 
ferent ! 
With this experience, nurses would be 
eager to change the laws that presently bind 
us, and it could provide the impetus to 
break the existing hiatus. - Bob Brown, 
R.M.N., S.R.N., Reg.N., and Phil Gower, 
Reg.N., The University of Western Ontario 
School of Nursing, London, Onto 


Unwed Father 
Dear Editor: 
Attention is continually being focused on 
the unmarried mother - her problems, 
fears, and responsibilities. I believe it is 
time that an investigation be made into the 
role of the putative or unmarried father. 
Granted, he can escape from the situation 
more easily than an unmarried mother, but 
he does not escape from thõse problems 
that caused his behavior in the first place. 
The putative or unmarried father is a 
man who produces a child as a result of 
intercourse out of wedlock and who subse- 
quently fails to marry the mother before 
the birth of the child. 
Until recently, the only consideration given 
to the problems of the putative father has 
been from a moral standpoint. The psycho- 
logical aspects are now coming under in- 
vestigation. A boy guilty of promiscuous 
behavior may be using girls to satisfy needs 
that were neglected in his early upbringing 
- needs for affection, attention, indepen- 
dence and acceptance. Other theories suggest 
that the putative father, although so insecure 
that marriage would be unthinkable, pro- 
duces a child to prove to himself that he is 
ready for marriage. 
Society seems to regard the unmarried 
father as a man who has "let the woman 
down" by not marrying her. This is often 
the case, but there are also many cases ill 
which the boy would be willing to marry 
the girl but she refuses or her parents will 
not allow it. In other cases the couple 


mutually agree not to marry. 
Looking on the financial side of things, 
there is the unmarried father whose cons- 
cience is headed by cash settlements. When 
this prostitute pattern is brought into the 
picture, the child becomes only the mother's 
in the sight of both parents. 
In contrast, there are men with true 
parental feeling for whom a cash settlement 
would do nothing but increase their sense of 
guilt. In the case of a young man who 
knows enough of modern psychology to 
realize the effect of deprived parenthood on 
a child, this sense of guilt may have a des- 
tructive effect on his later relationships with 
his legitimate children. 
The unmarried father will find it hard 
to go to a welfare office for help. He 
always expects severe treatment or at least 
trouble. Knowing that society still regards 
him in a criminal light, he tends to stay 
away from any official person or body no 
matter how much he needs help. It is easy 
to see that some of the apparent irresponsi- 
bility of the unmarried father is due to the 
fear he has of social censure. He particularly 
distrusts women social workers because he 
does not think that they will understand the 
man's point of view. 
[ believe that if the many mysteries sur- 
rounding the unmarried father are to be 
removed, society must adopt a new attitude. 
Instead of isolating the putative father, it 
should treat father, mother, and child as an 
originally linked problem. Only with such an 
approach can society avoid the increasing 
number of adoptions and help to establish 
new families from people who originally saw 
nothing ahead but a life filled with problems 
that they could not solve. - Miss Helen 
Staat, intermediate nursing student, Royal 
Columbian Hospital, New Westminster, B.C. 


Unfair to blame nurses 
Dear Editor: 
I just read the distressed reader's letter 
in the November issue, complaining about 
the indifference of a nurse toward her while 
she was in labor. 
I do not like to see a hospital described 
as turning out poor nurses - as the reader 
implies in her letter - because I think that 
rather the opposite is true; nor do I like 
to see somebody jumping to the conclusion 
that all nurses are bad nowadays, because 
one nurse possibly slipped up somewhere. 
[ said "possibly" because, after all, the nurse 
probably had her instructions from the doc- 
tor, and they might well have been different 
from what the patient thought they were. 
Any nurse who has worked in obstetrics 
(Continued on page 6) 
JANUARY 1967 




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THE CANADIAN NURSE 5 


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letters 


(Continued from page 4) 
has come across the case where the doctor, 
for various reasons, does not want to give 
anything for pain until he absolutely has 
to. And funhermore, where was the lady's 
doctor? Did he induce labor - at night! - 
and then go home? And did he phone back 
or come in person to che;:k his patient's 
progress? She says nothing about that. 
I think it is most unfair of her to put 


all the blame for her neglect, if there was 
any, on the nurses. They were probably 
overworked. and expected her, of all pa- 
tients, to have understanding in the situation. 
The only thing that bothers me in that letter 
is that the nurse who came on duty at 11 :30 
P.M. did not go in to check the patient. 
Probably there was a good reason why she 
didn't. but it would have been better if she 
had. Above all, it would have reassured the 
patient to know that somebody was keeping 
an eye on her. From the tone of the letter it 
seems obvious that reassurance was what she 
needed most. - Mrs. M.E. Mueller, R.N., 
Nonh Battleford, Saskatchewan. 


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THE CANADIAN NURSE 


Refresher course in Manitoba 
Dear Editor: 
In answer to the letter from "R.N. Mani- 
toba" and her comment regarding refresher 
courses (September 1966): St. Boniface Gen- 
eral Hospital will be conducting its fourth 
six-week refresher course in February and 
early March of 1967. 
Any nurses from the Winnipeg area inter- 
ested in this course can obtain more infor- 
mation by writing to the Co-ordinator, In- 
service Education, St. Boniface General Hos- 
pital, St. Boniface, Manitoba. - (Mrs.) K. 
De long. Winnipeg, Manitoba. 


Compliments 
Dear Editor: 
We have noticed with great pleasure the 
numerous innovations which have been in- 
corporated into both The Canadian Nurse 
and L'infirmière canadienne. 
Furthermore, we appreciate that the 
French edition is not a word for word 
translation of the English. 
We would like to congratulate each and 
every member of the editorial staff, hoping 
that they will keep up their enthusiasm in 
order to maintain the spirit of the magazine 
and make it even livelier. - Sister Claire 
Bilodeau, Director of the School of Nursing. 
Hôpital du St-Sacrement, Québec. 


Dear Editor: 
Every month after reading THE CANADIAN 
NURSE I think that I should write to ex- 
press my appreciation for the very fine 
issues we are receiving. I have procrastinat- 
ed long enough, so here are my sincere 
thanks for a difficult job well done. 
This letter was prompted by the opinion 
expressed by Dr. R.W. Sutherland in his 
article "Needed: Nurses Who Are Clinical 
Specialists" (Sept. 1966). I agree with I 
every word he wrote. - K. Deathe, Toron- 
to, Onto 


Dear Editor: 
The Nursing Sisters' Association of Can- 
ada, Montreal Unit, express appreciation and 
thanks for the anicles and photographs 
published in the November issue. 
Greetings and good wishes to the staff 
of THE CANADIAN NURSE. - Nancy Kennedy- 
Reid, National President and I. O'Reilly, 
President, Montreal Unit. 


Dear Editor: 
I have just received the September issue 
of THE CANADIAN NURSE. I am an Alberta 
graduate and am currently registered in B.C. 
The new concepts that are prevalent in 
nursing today never cease to amaze me. 
I am proud to say I am a nurse, and also 
a Canadian. 
Keep up the good work, we all can learn 
from one another. - E.M. Harrison, R.N., 
Chemainus, B.C. 0 
JANUARY 1%7 



news 


Dublin-Born Nurse 
to Study in Canada 
Sister Genevieve, S.R.N., principal tutor 
at the Mater Infirmorum Hospital, Belfast, 
will study nursing education in Canada as 
a result of winning the 1966 Glaxo Scholar- 
ship administered by the British Common- 
wealth Nurses' War Memorial Fund. 
This is the eight successive year that 
Canada has been chosen by a Glaxo Scho- 
lar as a training center. 
Sister Genevieve, who was presented with 
her award by Queen Mother Elizabeth at a 
birthday reception at St. James's Palace to 
celebrate the 21st anniversary of the Fund, 
will arrive in Montreal early in April. She 
will study post-basic courses in obstetric 
nursing, operating room nursing, and 
psychiatric nursing at the Royal Victoria 
Hospital. 
The E500 scholarship will also take her 
to Toronto, New York, Washington, D.C.. 
St. Louis, San Francisco, and Chicago. 
The Glaxo Scholarship is one of several 
available through the British Commonwealth 
Nurses' War Memorial Fund. It was set up 
in 1945 as a memorial to the 3,000 nurses 
and midwives of the British Commonwealth 
who lost their lives in the Second World 
War. The Fund has to date sponsored over 
150 scholars and two research fellows. 


UWO School of Nursing 
Sponsors Fifth Seminar 
To assist senior nursing executives toward 
better job performance, the school of nursing 
of the University of Western Ontario has 
arranged an II-day seminar June 12-23, 
1967. 
Sessions are planned for six days, Monday 
through Saturday noon the first week; for 
five days, Monday through Friday afternoon, 
the second week. Featured speakers will 
include Mother M. St. Michael, professor of 
philosophy, Brescia College, UWO; Dr. 
Catherine M. Norris, nurse educator and 
author, formerly professor of nursing at 
the University of New Mexico; Dr. R. Hodg- 
son, associate profe.ssor of the school of 
business administration, UWO; and Dr. 
Elizabeth Hagen, professor of psychology 
and eduoation at Columbia University. 
Interspersed throughout the two-week 
program will be lecture-discussion sessions, 
group analyses of cases, films, role-playing 
and individual guided study. 
Enrollment will be limited to 75 appli- 
cants who will be selected on the basis of 
their present positions and responsibility for 
administration. Efforts will be made to 
select a representative group from nursing 
JANUARY 1%7 


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Queen Mother Elizabeth presents the 1966 Glaxo Scholarship to Sister Gene- 
vieve of Dublin. This scholarship, administered by the British Commonwealth 
Nurses War Memorial Fund, will enable Sister Genevieve to study nursing 
education in Canada during the coming year. 


service administrators in hospitals, nursing 
service administrators in public health, nurs- 
ing education administrators, and adminis- 
trators and consultants in professional or- 
ganizations. 
The course fee is $250 to include classes, 
study materials, lodging, and meals. Appli- 
cation forms, which should be completed 
and returned to the School prior to March 
I, 1967, are available upon request. 


CNA Publishes Guide 
for Two-Year Diploma Programs 
A guide dealing with the development of 
two-year diploma programs in eduoational 
institutions has just been published by the 
Canadian Nurses' Association. 
Approved for publication at the pre- 
convention executive meeting, it is designed 
for educators considering such programs, 
whether in a community college, junior 
college, vocational school or technical school. 
Called Guiding Principles fOr the Develop- 
ment of Programs in Educational Institu- 
tions Leading to a Diploma in Nursing. the 
document covers planning and investigation, 
organization and administration, faculty, 
students, curriculum and instruction. and 
physical facilities. 
The publióation is available upon request 
from the CNA. Price $1.00. 


New Brunswick Nurses Take 
Important Step in Nursing 
Education 
The New Brunswick Association of Regis- 
tered Nurses has asked the provincial 
government to take immediate steps to 
implement the pIan for the education of 
nurses and health workers generally, as ad- 
vocated in Portrait of Nursing by Dr. 
Katherine MacLaggan. 
The nurses' request to government has 
been supported by citizens' committees from 
all areas of the province chaired by Dr. 
Allan Sinclair of the University of New 
Brunswick law faculty. 
The proposals for the new system of edu- 
cation concern a variety of health workers 
described as Nurse Grade I, Nurse Grade II, 
Wardkeeper and Ward Secretary. 
Both nursing groups would be prepared 
at the post high-school level within the 
province's genel1al educational system. The 
Nurse Grade I would constitute 75 percent 
of the nursing complement and would be 
eduoated in a two-year period at new health 
institutes recommended for Saint John. 
Moncton, and Campbellton. Twenty-five per- 
cent of the nurses, called Nurse Grade II, 
would be educated in New Brunswick's two 
established university schools of nursing. 
THE CANADIAN NURSE 7 



news 


The proposed heaith institutes wouid aiso 
educate the ward secretary and other per- 
sonnel for the health field and would be 
administered by an independent council res- 
ponsible to the minister of education. 
Envisioned under the program would be 
a phasing-out of existing schools of nursing 
over a period of years when newly-trained 
staff become available. It is estimated that 
from the start at any given time, a period 
of three years would be necessary for 
implementation. Existing health personnel 
trained under the present system would be 
retrained and protected on staff while new 
trainees would be trained under the propos- 
ed new system. 
The plan suggests that the first pilot 
health institute be established in Saint John 
because of important community facilities, 
especially in an institute in close proximity 
to St. Joseph's and the Saint John General 
Hospitals. 
A Moncton institute on or near the Uni- 
versity of Moncton campus which would 
provide easy access to hospitals, arts and 
science facilities is recommended. 
A third institute is invisioned in Camp- 
bellton to serve between 300-400 students 
at a cost of between one and two million 
dollars. 
The NBARN suggests that the capitaJ cost 
of such institutes be born by the province 
which would be able to avail itself of heaJth 
resources grants from the federal govern- 
ment. 
The plan, which was published in 1965, 
has been endorsed by the Canadian Nurses' 
Association. 


Alberta Nurses Serve in Africa 
Two instructors from the Foothills Hos- 
pital school of nursing are in Geneva being 
briefed for World Health Organization as- 
signments in West Africa. 
Margaret Svennin
n and Terry Knapik 
left Calgary New Year's Eve for WHO's 
headquarters at the Palais des Nations. 
Before taking up their two-year appointments 
in Ghana and Gambia they will stop over 
at Brazzaville in the Congo for further 
orientation. 
Miss Svenningsen will be teaching psy_ 
chiatric nursing at the University of Ghana. 
This is pan of a two-year course for grad- 
uate nurses. Her duties will include develop- 
ing the mental health aspects of the cur- 
riculum and also training a native African 
counterpart. 
Two hundred miles away, Miss Knapik 
will be teaching public heaJth in the school 
of nursing at Bathurst. She will also train 
a native African counterpart and will be an 
advisor to the Minister of Public Health 
in Gambia. 
8 THE CANADIAN NURSE 


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Nurses Recognized by Order of St. John. Three prominent members of 
the nursing profession pause for a photograph in the foyer of Government 
House in Ottawa after the Annual Investiture of the Order of St. John in 
Nov.ember. They are, left to right: M. Pearl Stiver, former executive director 
of the Canadian Nurses' Association; M. Christine Livingston, former 
director-in-chief of the VON, and Margaret M. Hunter, chief nursing 
officer for St. John Ambulance in Canada. Miss Stiver and Miss Livingston, 
co-authors of St. John Ambulance's new Home Nursing textbook "Patient 
Care in the Home," which was released earlier this year, were honored 
with the rank of Commander Sister by the Order of St. John. 


Both nurses plan to remain with WHO 
following their tour of duty in West Africa. 


Home Care Topic for Institute 
Dalhousie University's school of nursing 
is sponsoring its 16th Annual Institute, 
February 8-10, 1967. 
The topic of the three-day workshop will 
be Co-Ordinated Home Care Programs. Mrs. 
Rosetta Lippe, assistant director of training 
and extended services in home care with 
New York's Montefiore Hospital, will be 
the conference leader. She will be assisted 
by members of the nursing and allied pro- 
fessions in the Atlantic provinces. 
The aim of this year's institute is to 
enable all branches of nursing to fully un- 
derstand Medicare's implications for home 
care. It will be held at the Victoria Gen- 
eral Hospital Nurses' Residence. Registration 
fee is $2.00. 


Medical Education 
Research Unit Established 
To find out what it takes to make a 
good doctor, the University of Toronto has 
established a medicaJ education research 
unit - the first in North America. 
The unit will include two medical doc- 
tors, one of whom is a professor of psy- 
chology and education, a data processing 
expert, and a statistician. They will seek 


answers to these questions: 
What are the quaJities needed in a mo- 
dern physician? 
What types of education, both general 
and specialized, will best prepare the doctor? 
What personal qualities are most likely 
to suit a student for the medical profes- 
sion? 
The research team does not expect to have 
the answers for about 10 years. 


Newfoundland Seminar 
"One of the Best" 
The recent two-day workshop sponsored 
by the ARNN'S committees on nursing edu- 
cation and nursing service has been termed 
"one of the best." 
It is the second workshop held this year 
and according to ARNN President Janet 
Story "enthusiasm and attendance exceeded 
expectations." There 
re over 226 regis- 
trants at the St. John's workshop and 100 
at the workshop in Gander. 
The seminar had as its theme "Analyzing 
Nursing Needs," with delegates discussing 
such topics as future planning to improve 
nursing care and team nursing. 
Consultant to the workshop was Mrs. 
Huguette Labelle, associate director of nurs- 
ing education at the Ottawa General Hos- 
pital. She addressed the delegates on the 
responsibilities of every team leader and 
emphasized the importance of such people 
in assuring good patient care. 
JANUARY 1%7 



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JANUARY 1%7 


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THE CANADIAN NURSE 9 



news 


(Comil/lled fro", paRe 8) 


Canadian Welfare Council Says 
Action Needed to Increase 
Health Manpower 
The Canadian Welfare Council urges im- 
mediate action to increase Canada's health 
manpower and improve the di
tribution and 
quality of personal health services during 
the period before the Medical Care Act is 
implemented. 


This is the gisl of a resolution from the 
Council's Board of Governors. addressed to 
the federal government and circulated to 
provincial premiers and minislers of health 
and welfare. 


Commenting on Ihe resolution, B. M. 
Alexandor. Q.c.. president of the Council 
said: "Like most members of parliament, 
including those in the government. we very 
much regret any postponement in the date 
of implementation. Apart from other con- 
siderations. the connection between poverty 
and untreated ill health is all too obvious, 
and adequate health care measures are es- 
sential to any realistic attack on poverty. 


ONE-STEP PREP 


with 
FLEET ENEMA: 
single dose 
disposable unit 
FLEET ENEMA's fast prep time obsoletes soap and 
water procedures. The enema does not require warm- 
ing. It can be used at room temperature. It avoids the 
ordeal of injecting large quantities of fluid into the 
bowel, and the possibility of water intoxication. 
The patient should preferably be lying on the left side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. Left 
: 
 
.. colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. If a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
And afterwards, no scrubbing, no sterilisation, no 
preparation for re-use. The complete FLEET ENEMA 
unit is simply discarded! 
Every special plastic "squeeze-bottle" contains 4Y2 
fl. oz. of precisely formulated solution, so that the 
adult dose of 4 fl. oz. can be easily expelled. A patented 
diaphragm prevents leakage and reverse flow, as well 
as ensuring a comfortable rate of administration. 
Each J 00 cc. of FLEET ENEMA contains: 
Sodium biphosphate. . . . . .. .... 16 gm. 
Sodium phosphate ................. 6 gm. 
For our brochure: "The Enema: Indications and Techniques", 
containing full information, write to: Professional Service 
Department, Charles E. Frosst & Co., P.O. Box 247, 
Monfreal 3, P.Q. 


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10 THE CANADIAN NURSE 



 


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'OUNDED IN CANADA IN 1Øgg 


Delay in improving health care is therefore 
most unfortunate, and we sincerely hope 
that il will be possible to advance the in- 
troduction of medicare from July I. 1968. 
We are also very concerned that prepara- 
lions for implementation and this. of 
course, means action by the provinces _ 
should not slow down in this interim 
period. It is all to easy to relax once the 
pressure of an urgent deadline is eased." 
On the question of health manpower and 
the dislribution and quality of services, Mr. 
Alexandor pointed out Ihat although the 
Medical Care Act provides the major mecha- 
nism for payment for medical care, strong 
concurrent action is needed on these other 
points if the program is to be truly ef- 
fective. 
.The Royal Commission on Health Serv- 
ices. while urging that initiation of a medi- 
cal care program should not wait for an 
increase in health service resources, never- 
theless strongly recommended a crash pro- 
gram to strengthen them", Mr. Alexandor 
said. "The Commission particularly referred 
to strengthening of health personnel, which 
is the first step in improving distribution and 
quality of services. We need to start now. 
through every means, public and private." 
Mr. Alexandor stated that the Council's 
resolution was prepared by its recently es- 
tablished Committee on the Health Aspects 
of Welfare. under the chairmanship of Dr. 
John E.F. Hastings of the University of 
Toronto School of Hygiene. 


Controversy Among Montreal's 
English-Speaking Nurses 
The English-speaking nurses of the Mon- 
treal region have decided to undertake 
collective bargaining to regulate their work- 
ing conditions. Thi
 change in attilUde 
toward colleclIve bargaining is partly because 
the Hospital Services Commission has tended 
to equalize salaries and working conditions 
throughout the province, and partly because 
the Association of Registered Nurses of the 
Province of Quebec has urged its members 
to use this means. 
At present two groups are competing to 
represent English-speaking nurses. The En- 
glish-speaking chapter of District 11 held 
a meeting on December 5, 1966, at which 
the members adopted a resolution urging 
the nurses of the chapter to form an asso- 
ciation to negotiate for working conditions. 
About 1,200 nurses were present at this 
meeting. During the following days, some 
5,000 nurses from the chapter were asked to 
vote in favor of the new Association and 
to sign a registration card. 
When this organizational procedure has 
been completed, the new association, which 
will most probably be called the United 
Nurses of Montreal, will immediately seek 
to become accredited as bargaining agent 
with the Labour Relations Board. 
(Continued on page /2) 
JANUARY 1967 



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news 


(Continued from page /0) 
The chapter president, Miss Moyra Allen 
told the press that the association will be 
independent of the large unions and will 
not resort to strike action. 
The Act regulating professional nursing 
in the Province of Quebe<:: stipulates in Ar- 
ticle 17 that "Each local association may 
negotiate. conclude and sign as agent. 
collective contracts or agreements with any 
category of employer." 
On the other hand, a group of nurses 
from the Jewish General Hospital. under 


the leadership of Miss Ruth Arnold, have 
already organized themselves, and have 
formed another organization known as the 
Metropolitan Association of Nurses. On 
November 24, 1966, this association asked 
for accreditation from the Labour Board 
and has begun recruiting nurses in other 
Montreal hospitals. 
At a meeting on December 8, 1966, this 
group declared that the chapter (through the 
United Nurses of Montreal) could not nego- 
tiate for nurses as a large number of its 
members were nurses who held administra- 
tive positions. Their lawyer. M. Marc La- 
pointe, also maintained that only the Metro- 
politan Association of Nurses could obtain 
the necessary accreditation to represent the 
nurses. According to Miss Arnold. the 


THE QUEEN'S PRINTER 


wishes to inform you that 
he is the exclusive sales agent 
in Canada for 19 International Organizations. 


Two of our International Organizations work for you and 
publish books intended for you. 


. WHO 
World Health Organization 


. FAO 
Food and Agriculture Organization 


Two of our International Organizations are concerned mainly 
with all aspects of the development of nations and human 
beings. 


. UN 
United Nations Organization 


. UNESCO 
United Nations Educational, Scientific and Cultural 
Organization 


Would you like to know more about their work, their publica- 
tions ? 
Would you like to receive a catalogue of their reports on re- 
search? 


Write to: 


THE QUEEN'S PRINTER, 
Ottawa r Canada. 


12 THE CANADIAN NURSE 


district 11 Chapter should limit its actions 
to problems of a professional nature. 
It is premature to predict the outcome of 
these associations. The provincial association, 
the ANPQ. is not taking part in this debate; 
it is strictly a matter between the English- 
speaking chapter District 11 and the Metro- 
politan Association of Nurses as autonomous 
organizations. 


Baccalaureate Awards in '681 
Students aiming for baccalaureate degrees 
in nursing may be eligible for Canadian 
Nurses' Foundation awards if Parliament 
approves a proposed change in the Founda- 
tion's Letters Patent. 
At the CNF annual general meeting held 
Tuesday, December 6, 1966, at CNA House 
in Ottawa, it was proposed that the Founda- 
tion awards, formerly available only to 
those enrolled in master's or doctoral degree 
programs, be extended to cover those seek- 
ing baccalaureate degrees. 
A favorable vote carried the proposed 
amendment to the CNF Letters Patent. Un- 
anamously passed was a member's resolu- 
tion that the awards' selection committee 
give priority to students enrolled in master's 
and doctoral courses. 
Awards to baccalaureate students will not 
be available during the 1967-68 term since 
Parliamentary approval must be secured 
before the proposal can be implemented. 
Elected to serve on the new board during 
1967 and 1968 were M. Jean Anderson. 
Verna Huffman, Mrs. Eva T. McCutcheon 
and Alma Reid, and five members of the 
CNA Board of Directors: Dr. Katherine 
MacLaggan, Mrs. Helen P. Glass, Phyllis J. 
Lyttle, E. Louise Miner, and Janet Story. 
These new board members will serve two- 
year tenns as approved by constitutional 
amendment at the general meeting in 1965. 


Canadian Nurses at Expo 67 
Schools of nursing across Canada are 
cooperating with the Canadian Nurses' Asso- 
ciation in providing the nursing personnel 
necessary for its exhibit at Expo '67. 
Twenty-one graduate nurses and 78 stu- 
dent nurses. on a rotating basis, will staff 
the ultra-modern "Nurses" Station for 
Intensive Observation" in the Man and 
his Health Pavilion. 
Equipped with telemetering and recording 
devices, television monitors and inter-com- 
munication equipment, the station has been 
specially designed to show Expo's millions 
of visitors how nurses will be trained to 
maintain continuous observation of patients' 
respiration rate, pulse, electrocardiograph 
pattern, and other parameters in providing 
intensive care. 
The graduate nurses will wear uniforms 
specially designed for the occasion with pins 
and caps of their respective schools. Student 
nurses will be in the distinctive uniforms of 
their schools. A roster of the participating 
schools and hospitals will be on one wall of 
the exhibit. 


JANUARY 1967 



news 


New Immigrants Protected 
Against Hospital Bills 
Newly-landed Immigrants entering Ont- 
ario without hospital insurance will in 
future be able to obtain temporary pro- 
lection from Blue Cross until their govern- 
ment hospital insurance takes over. 
Hospital insurance regulations in Ontario 
:md most other Canadian provinces require 
new applicants to wait approximately three 
months before becoming eligible for bene- 
fits. Until now. no alternative coverage has 
been available during this interim period, 
and the individual immigrant (or his sponsor) 
ha
 been exposed to the possibility of heavy 
hospital bills. 
The new "Landed Immigrant"' plan re- 
cently announced by Ontario Blue Cross 
an
wers this threat by taking care of any 
hospital expenses up to a maximum of $30 
a day, the average daily hospital charge in 
Ontario. To obtain this coverage for a 
maximum period of 90 days (or until 
government hospital benefits become ef- 
fective. whichever is sooner). the individual 
immigrant will pay to Blue Cross one 
premium of $ 14.94. The cost to a family, 
consisting of husband. wife and unmarried 
children up to age 21. will be $28.98. As 
the "Landed Immigrant" coverage cannot be 
continued beyond 90 days, it will still be ne- 
cessary for an immigrant to apply for govern- 
ment hospital insurance immediately upon 
arrival here to avoid a gap in protection. 
Although the 90-day hospital coverage is 
at present available only to persons immi- 
grating to Ontario, Blue Cross Plans in other 
provinces have expressed interest in offering 

imilar protection to their own immigrants. 


Immunity Test 
for German Measles 
A test for detecting immunity to rubella. 
commonly known as German measles, has 
been developed by scientists of the U. S. 
Public Health Service's National Institutes of 
Health. The test, called hemagglutination-in- 
hibition (H-I), was developed in the Division 
of Biologics Standards' Laboratory of Viral 
Immunology of which Dr. Meyer is chief. 
The rubella H-I test employs the biolo- 
gical principle of hemagglutination or red 
blood cell clumping, used successfully in 

tudies on influenza and other diseases. Dr. 
Meyer and his co-workers found that special 
preparations of rubella virus cause the red 
blood cells of newly hatched chicks to 
clump. When they added a sample of 
blood from a person immune to German 
measles, the antibodies in the immune blood 
inhibited clumping. Thus. the inhibition of 
agglutination demonstrates the presence of 
antibody and immunity. 
The new test is so simple and reliable 
that a physician can determine within three 
JANUARY 1967 


Medical Care at Expo 67 


About 30,000 to 42,000 persons will 
require medical care during the six-month 
International Exhibition in Montreal this 
summer - and Expo 67 officials will 
be ready for them. 
Medical aid at Expo will be provided 
in two main types of facility: first aid 
stations and medical aid clinics. As well, 
more than 1,500 personnel will be pre- 
pared to administer emergency first aid 
treatment on the spot. 


Medical Aid Clinic 


Four Medical 
Aid clinics will 
be set up, one 
in each sector 
- Mackay Pier, 
lie Sainte-Hélè- 
ne, La Ronde, 
and TIe Notre- 
Dame. Each of 
these will be a 
IO-bed hospital with facilities and staff 
to care for patients for up to 24 hours. 
if necessary. 
Negotiations are in progress to have 
the clinics serve as an extension facility 
of four of the larger Montreal hospitals. 
Patients requiring longer term hospitaliza- 
tion or more intensive care than the lO- 
bed facility can offer will be transferred 
to one of the larger institutions. 
Clinics will have two wards - one of 
four beds, another of six - kitchen. re- 
ception. treatment and service rooms. 


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First Aid Posts 
As well as the clinics, there will be 


hours whether an expectant mother has anti- 
bodies against the disease. It is also capable 
of detecting immunity years after infection. 
The major hazard of rubella virus lies 
in the risk of its transmission to the fetus 
during early pregnancy, resulting in such 
defects as blindness. deafness. congenital 
hean disease. and brain involvement result- 
ing in mental retardation. 
Since the new immunity test is so inexpen- 
sive and easy to perform, it is expected to 
become routinely available in hospitals. 
health depanments. and other laboratories 
within the near future. 


leukemia and Mongolism 
Investigated 
A paper prepared by the National Cancer 
Institute. National Institutes of Health. 
Bethesda, Maryland, examines the effects 
of maternal age and binh order on the risk 
of mongolism and leukemia. Authors 
Charles Stark and Nathan Mantel study 
children born in Michigan during 1950-64. 
They discovered a striking association 
between maternal age and mongolism. but 


two first aid posts in each sector. These 
will be open from 9:00 a.m. to 1:00 a.m. 
and will be staffed by St. John Ambu- 
lance personnel. 
Many of the pavilions and exhibit 
areas are also planning first aid facilities. 
These will work 
closely with the 
Expo-sponsor- 
ed services. 
Six ambulances 
will be provided 
for transpon of 
patients on the 
Expo grounds 
and for taking 
patients to city hospitals. 


Forecasts 
Expo officials are expecting about 
270,000 people to visit the huge site 
each day. Based on statistics from the 
Brussels. New York, and cther major 
exhibitions. about 380 people will require 
treatment for first aid each day; I 15- ISO 
will be referred to Medical Aid Clinics; 
and about 8 to 20 will require hospitali- 
zation. Facilities are expected to handle 
this number with relative ease. 
The most common disorders anticipated 
to require medical care at Expo are: 
minor cuts, falls. sprains, heat stroke, 
hean attacks. food poisoning. drownings. 
and maternity cases. 
In addition, Expo has worked closely 
with the Quebec Government Emergency 
Measures Organization to prepare a dis- 
aster plan for the area. 


found that birth order did not independently 
affect the ri
k of mongolism. On the other 
hand, both maternal age and birth order 
independently affected the risk of death 
from leukemia. 
Risk of death from leukemia decreased 
with advancing birth order and increased 
with advancing maternal age. Except for the 
older maternal age groups, these trends for 
leukemia are in contrast to the effects of 
maternal age and binh order on death due 
to all causes. This contrast suggests that 
maternal age and binh order may be closely 
associated with the etiological agents of 
childhood leukemia. 


Ontario Hospital Receives Grant 
National Health and Welfare Minister 
Allan J. MacEachen has announced that a 
federal grant of $281,938 for the Leaming- 
ton District Memorial Hospital has been 
approved. The grant will assist construction 
and renovation programs for the hospital. 
A new addition will provide space for 
80 active treatment beds and 14 chronic 
care beds. 


(Continued on page 14) 
THE CANADIAN NURSE 13 



news 


(Continued from paRe 13) 


Renovations will improve patients' rooms 
in the existing building. They will also pro- 
vide for improving and expanding the kit- 
chen, x-ray depanment, laboratories, deliv- 
ery and operating rooms. 
The work is expected to be completed 
next month. 


Parents Enthusiastic 
About Hearing-Test Program 
A new program to detect hearing defects 
in newborn children has been launched at 
the Jewish General Hospital in Montreal. 
Dr. David Halperin, otolaryngologist-in- 
chief of the hospital. said the object of the 
program is to develop normal speech in the 
deaf child so that he may attend regular 
school classes by the time he reaches school 
age. "Until now, even though hearing loss 
in children could be detected at an early 
age, nothing could be done for them. This 
hearing loss resulted in development of 
speech defects," he said. 
Three different, small, ponable machines, 
which have recently become available, can 
test hearing ability within days after birth. 
This breakthrough makes it possible to in- 


stitute the corrective program at the hos- 
pital. When deafness is detected in a child 
at binh, he can now be supplied with a 
hearing aid by the time he is six months old. 
Parents of newborn children at the Jewish 
General Hospital have responded enthusias- 
tically to the project. Upon admission to 
hospital, the mother-to-be receives a bi- 
lingual leaflet explaining the program. 
The leaflet says that "the incidence of 
hearing loss at birth is very small - one out 
of a thousand newborns will have such a 
problem. If this one in a thousand is de- 
tected within the first few weeks after birth, 
the development of speech defe.::ts will be 
avoided by taking immediate and appro- 
priate training and educational measures." 
To test as many infants as possible, the 
hospital's clinic for communication disorders 
is working closely with its pediatric clinic 
and with the Herzl Health Service Centre. 
The cooperation of private pediatricians has 
also been obtained. 
The hearing testing program is twofold. 
Under the supervision of the hospital's au- 
diologist, Miss Sylvia Dubitsky, specially 
trained volunteers conduct tests either in 
the mother's room or in the nursery. After 
repeated testing to confirm the findings, 
any infant whose hearing is found to be 
impaired is sent to the McGill Project for 
Deaf Children for education and training. 
The McGill Proje.::t is under the direction of 


Facts about 
Registered Nurses 
in Canada 


Source: Research Unit, 
Canadian Nurses 
Association, 1966 


14 THE CANADIAN NURSE 


age 


Daniel Ling, fonnerly principal of the Oral 
School for the Deaf and a leading authority 
in his field. The Project is staffed by teach- 
ers specially trained for the work. 
The Royal Victoria and Queen Elizabeth 
Hospitals are both setting up hearing test- 
ing programs similar to that now in opera- 
tion at the Jewish General Hospital. 
"It is our ultimate aim to make it pos- 
sible for every child with congenital hearing 
defects to attend a regular school at school 
entrance age," said Dr. Halperin. "There 
is no need, with all the facilities available, 
for any child to be isolated as a handicapped 
individual." 


Anti-Smoking Measures Continue 
A Smoking Withdrawal Study Center has 
opened in Toronto under the direction of 
Dr. N. Delarue of the University of Toron- 
to and Dr. G. W. O. Moss, Deputy Medical 
Officer of Health for the City of Toronto. 
This experimental center hopes to deve- 
lop new approaches to assist adults to stop 
smoking as well as to determine reasons for 
the successes or failures observed. 
One of the basic objectives of the Can- 
adian Smoking and Health Program is to 
encourage smokers to discontinue the habit. 
Through health education it is also endea- 
voring to dissuade non-smokers from acquir- 
ing the habit. 



 


35 - 44: 20.3 % 


II 


45 - 54: 15.0 % 


g 


55 and over: 
10.5 % 


. 


Age not reported: 
7.9% 


&I 


24 & under: 12.7 % 


o 25 - 34: 33.7 % 


JANUARY 1967 



news 


PMAC Head Urges Stronger 
Patent Laws 
The Pharmaceutical Manufacturers Asso- 
ciation of Canada believes that stronger pat- 
ent laws are needed to encourage pharmaceu- 
tical production and research in Canada. 
Association president, Dr. Wm. W. Wigle, 
told the Commons Special Committee on 
Drug Costs and Prices recently that patents 
and the economic incentives they provide 
are essential to the discovery and continuing 
flow of health-restoring and life-saving phar- 
maceuticals. 
Stressing the dangers inherent in any sug- 
gestion that drug costs could be lowered by 
abolishing patents, Dr. Wigle said "from 
a therapeutic point of view it would be a 
medical catastrophe because research for 
new cures would be seriously arrested." He 
suggested that from an economic point of 
view it would destroy a growing industry 
and reduce it to nothing more than a collec- 
tion of import houses and imitators. 
PMAC's patent advisor, Gordon Hender- 
son, Q. c., pointed out to the committee 
that a patent not only encourages inven- 
tion through research but constitutes an 
incentive to production. "The abolition of 
patents would lead to the Canadian market 
becoming dependent upon foreign producers 
with the risk that necessary drugs might be- 
come unavailable in times of great need," he 
said. 
The association recommends that patent 
protection for drugs be strengthened by per- 
mitting patents on drug products rather than 
just on manufacturing processes as at present. 


Manitoba Doctors Want 
Higher Pay 
Manitoba doctors have threatened to with- 
draw from the province's doctor-operated 
medical insurance plan unless their demands 
for higher remuneration are met. 
The Manitoba Medical Service covers 
about 600,000 of the province's 1,000,000 
people. Doctors now receive payment on the 
basis of 80 percent of their operating fee 
schedule. They want 100 percent and threa- 
ten to withdraw from the plan by July I, 
1967, if they do not get it. 
At a special meeting of the Manitoba Me- 
dical Association, some 200 doctors endorsed 
a resolution by president-elect, Dr. G. E. 
Mosher, asking that MMS achieve full pay- 
ment of the fee schedule by mid-1967. 
According to Dr. Mosher, the pro-rating 
principle was used when MMS was establi- 
shed because it was needed to keep the ser- 
vice solvent and the service was intended 
for low-income subscribers. "We cannot 
stand aside and idly watch economic factors 
wear away our standards until we are giving, 
and are receiving, assembly-line medicine." 
Dr. Mosher said that if the MMS failed 
JANUARY 1967 


to comply with the resolution, he would 
ask every doctor in Manitoba for a signed, 
undated letter, opting out of the plan. 
If the doctors' demand is met, it could 
mean an increase in MMS subscriber fees of 
between 20 and 25 percent. 
Doctors say if !hey pull out of MMS, 
their services will still be available to their 
patient
 - but on a direct basis. 


U.S. Study Reveals Shortage 
of Hospital Personnel 
A new study of health manpower sup- 
ply and needs in United States' hospitals 
reveals significant shortages in all categories 
of professional and technical personnel. 
The U.S. Department of Health, Educa- 
tion and Welfare announced recently that 
comprehensive information on hospital man- 
power is now available from a study made 
jointly by the American Hospital Associa- 
tion and the Public Health Service. 
The study was made to determine the 
number of personnel employed, current 
vacancies, and estimates of personnel needs. 
Data from the first 4,600 hospitals which 
reported have been used to estimate totals 
for all 7,100 hospitals in the United States 
registered by the American Hospital Asso- 
ciation. These reports indicate that the total 
number of professional, technical, and auxi- 
liary personnel employed in hospitals is 
about 1.4 million. About 275,000 additional 
professional and technical personnel would 


In the Nightingale Tradition 
I' 


\ 




 


At a dinner party in Victoria, British 
Columbia, 40 members of the Victo- 
ria Unit of the Nursing Sisters' Asso- 
ciation of Canada heard Mrs. G. 
Stewart, who was dressed to repre- 
sent Florence Nightingale, read an 
address originally given by Miss 
Nightingale to her students at St. 
Thomas' Hospital, England, in 1881. 
The theme of the evening was "Cen- 
tennial," and many of those attend- 
ing wore period costumes. 


be needed to provide optimum patient care, 
an increase of about 20 percent over present 
staffing. Over 80,000 more professional 
nurses and more than 40,000 practical 
nurses are needed. Some 50,000 aides are 
needed in general hospitals; another 30,000 
in psychiatric institutions. Over 9,000 more 
medical technologists, almost 7,000 social 
workers, and about 4,000 more physical 
therapists, x-ray technologists, and surgical 
technicians are needed. 
Most urgent needs are for nurses, practical 
nurses, and aides. High on the urgent list, 
too, are medical technologists, laboratory 
assistants, radiologic technologists, dietitians, 
physical therapists, occupational therapists, 
and social workers. 


Cmadian-Designed Device 
Measures Hidden Skull Pressure J 
A University of Saskatchewan biomedical 
engineering student has developed a device 
to measure intracranial pressure precisely. 
The instrument, created by Gerald Wade, 
was described at the Canadian Medical and 
Biological Engineering Conference in Otta- 
wa. It may permit diagnosis of such serious 
conditions as hydrocephalus in infants be- 
fore brain damage occurs. 
A fluid-filled transducer is placed against 
the fontanelle. The transducer feeds into 
an electronic recording device that gives a 
dial reading. The instrument makes 20 se- 
parate determinations of the cerebrospinal 
fluid and provides a visual readout of the 
average fluid. 
The device is presently being used as a 
research instrument. Mr. Wade sees wide 
potential use for it in routine screening of 
newborn infants for the detection of ab- 
normal intracranial pressures. 


Two-Day Conference Set on 
Rural Health 
Rural-urban Health Relationships will be 
the theme of the 20th National Conference 
on Rural Health to be held March 10-11, 
1967, at Charlotte, North Carolina. 
The conference will explore new needs and 
report on new developments in community 
planning and responsibility for health fa- 
cilities and services; future patterns of per- 
sonal health care; rural accident prevention 
and first aid instruction; and health man- 
power - planning and utilizing. 
There is no registration fee for the con- 
ference, which will convene at 9:00 A.M.. 
Friday, March 10. Registration opens at 
7:30 A.M.. March 10. 
Cooperating organizations include Co- 
operative Extension Services, Farm Organi- 
zations, Medical Associations and Auxilia- 
ries, Health Departments, Allied Health Or- 
ganizations, Women's Groups, Agricultural 
News Media, and Continuing Education 
Groups. 
Further details are available from the 
Council on Rural Health, American Medical 
Association, S3S North Dearborn Street, 
Chicago, Illinois, 60610. 
THE CANADIAN NURSE 1S 



names 


With "no intention 
of reminiscing about 
past efforts, past fai- 
lures, missed opportu- 
nities. small accom- 
plishments," Dorothy 
M. Percy retires. J an- 
uary 6, 1967, as chief 
nursing consultant for 
the Department of 
National Health and Welfare. 
Her many friends. admirers and colleagues 
who honored her at a testimonial dinner 
last September did not share her concepts 
of herself. 
She was recognized by Katherine Mac- 
Laggan, president of CNA, as "a woman 
who is an advisor on nursing, a consultant 
on nursing, a remarkable nurse, a pioneer, 
a success in the eyes of her peers and a 
recipient of love." 
Miss Percy, born and educated in Ottawa, 
began her nursing career in 1924 with her 
graduation from the Toronto General Hos- 
pital School of Nursing. The following 
year she qualified in public health nursing at 
the University of Toronto. 
Before joining the Victorian Order of 
Nurses in 1927, Miss Percy served as head 
nurse in the medical ward of the Ottawa 
Civic Hospital. It was while she was in 
charge of publicity at national office that 
Miss Percy organized the VON's first mari- 
onette show at the Toronto Exhibition. 
From 1934 to 1941 she was part of the 
teaching faculty of the University of Toron- 
to. Immediately following her teaching 
career, Miss Percy enlisted with RMAC, and 
after a year at the Camp Borden Military 
Hospital. proceeded overseas to Canadian 
General Hospitals in Great Britain. She re- 
turned to Canada in 1944 and was appointed 
matron at the Petawawa Military Hospital. 
Following the war, Dorothy Percy served 
as executive secretary of the Division of 
Health of the Welfare Council of Toronto. 
A year later. 1947. she was appointed to 
head the new division of nursing under the 
Department of National Health and Welfare. 
In 1953, Miss Percy was appointed chief 
nursing consultant to the Department of 
National Health and Welfare, in which ca- 
pacity "she has been called upon to inter- 
pret government policy and suggest the ap- 
propriate ways and means of attaining objec- 
tives." 


" 


""':; , 


.
 


- 


... 


Plans for retirement? Miss Percy says, ". 
can't answer that at the moment. I'm much 
too busy getting down to the dreary chore 
of cleaning out desk drawers and filing 
cabinets!" 


16 THE CANADIAN NURSE 


Mildred Irene Wal- 
ker, senior nursing 
consultant in the occu- 
pational health divi- 
sion of the National 
Health and Welfare 
Department, retired 
November 30. 1966. 
Her busy and vari- 
ed nursing career be- 
gan in 1924 with her graduation from the 
Victoria Hospital School of Nursing. Lon- 
don. Ontario. The following year, Miss 
Walker received her certificate in public 
health nursing from the University of West- 
ern Ontario. 
Miss Walker's nursing career has been 
largely administr.ative. Following a short 
period of private duty nursing at Victoria 
Hospital, London, Ontario. she became a 
public health nurse in the town of Weston, 
Ontario. 
After two years she joined the staff of 
the Ontario department of health where she 
worked for three years. In 1930 Miss Walker 
joined the faculty of the University of West- 
ern Ontario as a lecturer. She later became 
an assistant professor of nursing and served 
as chief of the division of study for gradu- 
ate nurses in the Institute of Public Health 
at the University. 
Upon completion of her advanced study 
at Columbia University, New York. Miss 
Walker accepted the position of supervising 
nurse at Phillips Electrical Company, Brock- 
ville. Ontario. 
In 1949 Miss Walker became senior nurs- 
ing consultant in the occupational health 
division of the Department of National 
Health and Welfare. Ottawa. In this posi- 
tion she was responsible for developing the 
present industrial nursing program. 
On her retirement. November 30, 1966. 
Miss Walker was looking forward to "the 
first leisurely Christmas in years. and future 
enjoyment of a summer cottage on the St. 
Lawrence River." 


" 


... 


A new member has 
joined the editorial 
staff of THE CANADIAN 
NURSE. Carla Dianne 
Penn, born in London. 
England, received her 
education in Canada. 
She attended the Uni- 
versity of Ottawa 
where she recently re- 
ceived her B.A. (English). Miss Penn as- 
sumed the position of editorial assistant 
in October. This is a new editorial position 
created to help meet the journal's expand- 
ing needs. 


--. 
- 


Cathryn Lillian Mar- 
tin, a native of Tex- 
as, joined the staff of 
McMaster University 
School of Nursing in 
Hamilton, Ontario. 
this year. This is a first 
Canadian position for 
Miss Martin, who is a 
graduate of the School 
of Nursing of Tuskegee Institute, Alabama. 
She also holds a B.Sc.N. from the Institute 
and an M.A. in curriculum and teaching 
maternal-child health from Columbia Uni- 
versity. New York. In 1965 she obtained 
her master of education with a major in 
guidance. 
Prior to her appointment as assistant profes- 
sor of nursing at McMaster, Miss Martin 
held positions in various hospitals and 
schools of nursing in Texas, including her 
most recent as assistant professor at the 
Tuskegee Institute. 


- 


A. Joyce Bailey re- 
cently assumed the po- 
sition of assistant di- 
rector of nursing ser- 
vice at The Wellesley 
Hospital, Toronto Ont- 
ario, Miss Bailey, a 
1956 graduate of The 
I Wellesley Hospital 
School of Nursing, re- 
ceived her B.Sc.N. from the University of 
Toronto in 1964. The following year she 
was awarded the Canadian Nurses' Founda- 
tion Scholarship and is presently completing 
her thesis for Western Reserve University, 
Cleveland, Ohio. 
Prior to her present position as assistant 
director of nursing service, Miss Bailey 
worked at various levels on the staff of The 
Wellesley Hospital, including general staff 
nurse, assistant head nurse and head nurse. 


Rita J. Lussier has 
been appointed nurs- 
ing coordinator at the 
Expo '67 pavillion 
__ "Man and His Health." 
Miss Lussier gradu- 

 ated from the School 
of Nursing of the Mai- 
sonneuve Hospital and 
later obtained nursing 
experience in cardiac surgery at the Mon- 
treal Children's Hospital. She received her 
baccalaureate in nursing science from J'lnsti- 
tut Marguerite d'Y ouville in 1962. During 
the next three years, Miss Lussier taught at 
the School of Nursing at the Maisonneuve 
JANUARY 1967 



names 


Hospital, ,md in 1965 ....,IS named ,I'sistant 
director of nursing service in charge of the 
inservice teaching program. 
Miss Lussier is on loan to Expo from the 
Maisonneuve Hospital. 


Lieutenant Colonel 
Muriel E. Everett. ad- 
ministrator of the 
Salvation Army Grace 
General Hospital. SI. 
St. James. Manitoba. 
recently received a fel- 

 lowship in the Amer- 
ican College of Ho-.- 
pital Administrators. 
Lieul. Colonel Everett, a native of Perth, 
Au
tralia. served with the Australian Forces 
in the Far East as a nursing sister and held 
various appointments in her homeland be- 
fore moving to Canada in 1951. She has 
held various positions in Canada. chiefly of 
an administrative nature. and has been ad- 
ministrator of the Grace General since I 96:!. 


Another addition to 
the McMaster Univer- 
sity School of Nursing 
staff is Gertrude Fran- 
ces Burns. Miss Burns, 
a graduate of the 
Marymount School of 
Nursing, Sudbury Gen- 
eral Hospital, Sudbury, 
Ontario, is a lecturer 
in medical-surgical nursing. 
After graduation Miss Burns worked as 
staff nurse on medical and surgical nursing 
wards at the Sudbury General Hospital. In 
1964 she went to McGill University in 
Momreal where she obtained a diploma in 
supervision and teaching and her bachelor's 
degree in nursing and nursing education. 
Between her university sessions and until 
her present appointment as lecturer, Miss 
Burns worked at The Montreal General 
Hospital. 



 
..J. 

 
-I 


.... 


.... 


The new director of nursing at the Kirk- 
land and District Hospital, Kirkland Lake. 
Ontario is Annikki Huhtanen. 
Miss Huhtanen. a 1940 graduate of the 
School of Nursing in Viipuri, Finland, 
served in the Finninsh Army nursing service 
for four years following graduation. The 
next four years she worked as a staff nurse 
at the Central Military Hospital, Helsinki. 
Miss Huhtanen moved to Canada in 1949. 
and immediately began nursing at The 
Montreal General Hospital. After four years 
she moved to the Temiskaming Hospital. 
Temiskaming, Quebec, and in 1955 she 
moved again, this time to the Stevenson 
Memorial Hospital, Alliston. Ontario. 
In 1960 Miss Huhtanen returned to Fin- 
land where she completed a course for di- 


JANUARY 1967 


rector
 and administrators in the nur,ing 
field. Upon her return to Canada, she be- 
came director of nursing. as well as super- 
visor-administrator at the Cottage Hospital. 
Uxbridge. Ontario. 
Now in Kirkland Lake, Miss Huhtanen 
takes over supervisory dUlie
 from Miss 
Gertrude Koivll. who is no.... working to- 
ward her nursing degree in Montreal. 
The new director of nursing spent two 
years in postgraduate study: one year in 
cero-bacteriology and one year in laboratory 
work in clinical hem otology. 
Her new duties include the charge of the 
nursing staff of 124 as well as responsibiiity 
for the staff of the central supply service 
and the operating room personnel. 


Grace Elisabeth Ter- 
ry, a 1963 graduate 
of the Victoria Hospi- 
tal. London, Ontario. 
is a new lecturer in 
nursing at Hamilton"s 
.J J McMaster University. 

 The past three years 
have been busy for 
Miss Terry. In 1964 she received her 
B.Sc.N. in nursing education from the Uni- 
versity of Western Ontario in London; 
throughout 1965 and 1966 she held positions 
as part-time lecturer in nursing at McMaster, 
general duty nurse at the Henderson Gen- 
eral Hospital, Hamilton, and, finally, as- 
sistant head nurse in the same hospital. 


Margaret G. Arnstein, well-known to 
Canadian nurses for her leadership in the 
profession, has retired from the U.S. Public 
Health Service to accept a professorship 
with the School of Public Health at the 
University of Michigan. 
As nurse director in the Service's Com- 
missioned Corps, Miss Arnstein had been 
heading a nursing unit to serve health pro- 
grams of the Agency for International 
Development, with special emphasis on the 
nurse and midwife role in the new programs 
of population control and nutrition. Her 
previous assignment was to the Rockefeller 
Foundation AID-Study of the preparation 
of health manpower in developing countries. 
From 1949 to 1964, Miss Arnstein direct- 
ed programs that promoted the effective 
utilization and expansion of nursing service 
skills in all the States, that stimulated and 
supported the advancement of research in 
nursing, and that influenced the improve- 
ment and growth of nursing education. She 
was instrumental in the development of both 
the U.S. Nurse Training Act of 1964 and 
the earlier legislation providing Federal 
traineeships to enable nurses to receive the 
educational preparation necessary for leader- 
ship positions. 
A graduate of the Presbyterian Hospital 
School of Nursing, New York, Miss Arn- 
stein earned her baccalaureate degree at 


. 


.. 



 



 


\ 


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have avoided if I'd known about COR- 
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CORRECTOL has been 'Specially developed 
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two gentle ingredients in CORRECTOL 
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CORRECTOL 


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COLOR SLIDE PROGRAMS 
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Contoin anatomicol diagrams and phOfos 
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TO: UNITEO SURGICAL SUPPLIES CO., INC. 
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pleose send me your FREE 
descriptive literature :# 738 C.N. 
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THE CANADIAN NURSE 17 



POSEY BELT No. 4157 
This Posey Belt may be used on a patient in 
a chair or bed. When used on a patient in a 
chair, it is slipped over the patient's head with 
the 51 iding section of the belt in the front of 
the patient. The long strap goes in back of the 
patient; the ends are taken back of the chair 
and hooked together. When this Posey Belt is 
usen on a patient in bed, it is sl ipped over the 
patient's head with the long strap at the pa- 
tient's back. Tl,e snaps on the belt are hooked 
to a strap with a liD" ring which has been 
attached to the spring rail of the bed_ Made of 
2" heavy webbing. May be laundered. Avail. 
able in small, medium and large sizes. No. 
4157. $9.90 ea. 


., (') 0 
. . . 


THE POSEY MITT 
To limit patient's hand activity. An adjustable 
strap attached to the mitt and the side rail ot 
the spring determine limit of movement. Can 
be laundered by ordinary methods. Comforta- 
ble, and prevents patient's scratching, pulling 
out catheter, nasal tube, etc. Available Small, 
Medium and Large. No. C-212-(both sides 
flexible) $6.30 each - $12.60 per pair. No. 
R-212-(palm side rigid) $6.60 each-$13.20 
per pair. 


, 


'i 


'. - 


. $'''' 
, - . 
.'i1 ( .t - 
" .' 4" 
...",
ð'"r 


... 


........ 


". 


WRIST OR ANKLE RESTRAINT 
A friendly restraint available in infant, small, 
medium and large sizes. Alsi widely used for 
holding extremity during intravenous injection 
No. P-450, $6.00 per pair, $12.00 per set. With 
DECUBITUS padding, No. P.450A, $7.00 per 
pair, $14.00 per set. 
POSEY PRODUCTS 
Stocked in Canada 
B. C. HOLLINGSHEAD LIMITED 
64 Gerrard Street, E. 
Toronto 2, Canada 


18 THE CANADIAN NURSE 


names 


(C01lt;I/I/Cc/ from pagc /7) 


Smith College, her master of arts in public 
health nursing from Columbia University, 
and her master of public health from the 
Johns Hopkins School of Hygiene and 
Public Health. She holds honorary degrees 
of doctor of science from Smith College and 
Wayne State University. 
Arlene Elizabeth Aish, Catherine Shirley 
MacLeod, Hazel Lillian Salmon, Sally Jane 
Miller, and Judith Anne Ritchie have re- 
cently joined the teaching staff of the School 
of Nursing, University of New Brunswick 
in Fredericton. 


Arlene Aish, a 1958 graduate of the SchOûI 
of Nursing, University of British Colum- 
bia, worked as staff nurse at the Vancouver 
General Hospital and as public health nurse 
with the Toronto Department of Health 
before continuing her studies. In 1961 she 
obtained her master of nursing from the 
University of Washington, Seattle, and 
worked for the next four years as a lecturer 
at the University of Toronto School of 
Nursing. Miss Aish is presently an assistant 
professor at the School of Nursing, Uni- 
versity of New Brunswick. 


Shirley Macleod, a native of Denmark, 
Nova Scotia, received her training at the 
l'"foncton Hospital School of Nursing in 
1949. The following year she completed an 
obstetrical clinical course at the Margaret 
Hague Maternity Hospital in Jersey City. 
N.J. The next seven years Miss MacLeod 
spent as obstetrical supervisor at the Monc- 
ton Hospital. Before taking up her new ap- 
pointment as lecturer at the University of 
New Brunswick School of Nursing, Miss 
MacLeod received her baccalaureate degree 
from McGill University and was obstetrical 
clinical instructor at the Moncton Hospital 
School of Nursing. 


.. 


Hazel Salmon, a 1946 graduale of The 
Montreal General Hospital School of 
Nursing, has covered much territory in her 
nursing career. After receiving a certificate 
in public health nursing from McGill Uni- 
versity, Miss Salmon spent three years as 

taff nurse with the New Brunswick Depart- 
ment of Health. From 1952 to 1955 she 

erved with the Victorian Order of Nurses 
in Woodstock, New Brunswick. Miss Salmon 
Ihen headed north to work with the Indian 
and Northern Health Services in White- 
horse, Yukon, for two years as public 
he ,11th nurse and then went west to the 
Calgary area for two years in the same 
capacity. In 1962 she obtained her bachelor 
of nursing from Dalhousie University, N.S.. 
and in 1964 her master of (applied) science 
from McGill. Prior to her present appoint- 
ment as lecturer at the School of Nursing. 


University of New Brunswick, Miss Salmon 
was supervisor of nursing with the Temis- 
kaming Health Unit, Kirkland Lake, Onto 
Sally Jane Miller, from Edmundston, New 
Brunswick, graduated from the School of 
Nursing, University of New Brunswick in 
1964. Following graduation, she worked as 
general duty nurse at the Hotel-Dieu de 
Saint-Joseph in Edmundston. Her new po- 
sition is clinical instructor at the University 
of New Bnmswick School of Nursing. 
Judith Ritchie is another new clinical in- 
structor at the U.N.B. School of Nursing. 
Miss Ritchie obtained her B.N. from the 
University of New Brunswick in 1965 and 
spent the following year as general duty 
nurse at the Montreal Children's Hospital. 
Margaret Harrison, Norma Jaenen, Edythe 
Huffman, Marie Knelsen, and Jessie Hibbert 
were recently appointed to the School of 
Nursing Faculty at the Calgary General 
Hospital. Returning to the Faculty after 
completion of studies are Coralea Toney, 
Elaine Parfitt, Barbara Dobbie and Judy Ban- 
natyne. 
Mrs. Harrison, a graduate in nursing 
science at the University of British Co- 
lumbia, is leaching surgical nursing. 
Mrs. Jaenen, an instructor in orthopedic 
nursing, obtained her B.Sc.N. from the Uni- 
versity of Saskatchewan. 
l'"frs. Huffman, a former graduate of the 
School of Nursing. Calgary General Hos- 
pital, served as senior health nurse in the 
Flin Flon, l'"fanitoba Health Unit, and also 
worked with the Winnipeg Health De p.! rt- 
ment prior to her new position. She is pre- 
sently instructor in obstetrical nursing. 
Mrs. Knelsen, another graduate of the 
School of Nursing, Calgary General Hospi- 
tal, obtained a diploma in public health 
nursing from the University of l'"faniloba. 
She is assistant instructor in nursing arls and 
also teaches pharmacology. 
Mrs. Hibbert, a new instructor in psychi- 
atric nursing, graduated from the Winnipeg 
General Hospital School of Nursing. She 
later attended the San Francisco State Col- 
lege where she earned her B.A. in nursing 
and her M.A. in education. At UCLA Mrs. 
Hibbert obtained her Master's in psychiatric 
nursing. 
l'"fiss Toney, a graduate of the Winnipeg 
General Hospital School of Nursing, has re- 
turned to the Calgary General Hospital 
School of Nursing after completing her 
bachelor of nursing degree at McGill. She 
is instructor in gynecology. 
Mrs. Parfitt. who recently compleled her 
B.Sc.N. at Ihe University of Alberta is teach- 
ing growth and development. ophthamology, 
and urology. 
Miss Dobbie, an instructor in pediatric 
nursing, obtained her bachelor of nursing 
degree from McGill University in Montreal. 
Mrs. Bannatyne, an instructor in medical 
nursing, recently earned her bachelor of 
science in nursing degree from the Uni- 
versity of Alberta. 


JANUARY 1967 



names 


An Honorary Life Membership in the 
Nova Scotia Branch of The Canadian Public 
Health Association was awarded recently to 
Edna Pitts who retired from public health 
nursing in 1964. 
The award was made in recognition of 
her "diligent and conscientious approach to 
nursing care" and for her many years of 
devoted service to public health nursing 
in Nova Scotia. 
Miss Pitts' busy nursing career began 
with her graduation from St. Mary's Hos- 
pital, Brooklyn, New York. A course in 
public health nursing at Columbia Univer- 
sity prepared her for the position of public 
health nurse with the Provincial Depart- 
ment of Health in Cape Breton, where she 
worked for two years. In 1939 she was 
transferred to the staff of Lunenburg- 
Queens-Shelburne Division and, in 1955, to 
the Atlantic Health Unit, a position she 
held until her retirement in 1964. 
Miss Pitts wiII long be remembered for 
her "family centered" approach to nursing 
and for her keen interest in the affairs of 
the community in which she worked. 


Anita Germaine has been appointed director 
:>f nursing service at the Scarborough Cen- 
enary Hospital, West HiII, Ontario. 
Miss Gennaine is a graduate of the Gen- 

ral Hospital School of Nursing. Pembroke, 
Ontario. Her experience includes nursing 
iervice, nursing education, and employment 
in various levels of management in a large 
ransportation industry. 
On her return from England in 1960, 
,he was assistant dean and consultant for 
an air career school, primarily interested in 
procedure, manuals and methods of per- 
ionnel training for various transportation 
agencies in Canada and Africa. 
Miss Gennaine joined the staff of Scar- 
borough General Hospital in 1963 as an 
instructor in the registered nurse assistant 
school, and from 1964 to 1966 was asso- 
::iate director of nursing service, coordinator 
of staff development and education pro- 
grams, and responsible for management de- 
velopment training within the hospital. 


Dianne J. Hoffinger and Alma M. Daisley 
were both awarded $1,000 bursaries from 
the Saskatchewan Registered Nurses' Asso- 
.:JÌation. 
Miss Hoffinger, a native of Regina, Sas- 
katchewan, is presently completing her 
nursing degree at the University of Al- 
berta in Edmonton. 
Miss Daisley, a 1963 graduate of the Sas- 
katoon City Hospital School of Nursing, is 
presently in her final year of the nursing 
program at the University of Western On- 
tario, London. 
The SRNA bursary fund was established 
JANUARY 1967 


in 1964 10 provide financial assistance for 
registered nurses in postgraduate studies or 
in the final years of baccalaureate programs. 
The fund is financed from interest received 
from association investments and from dona- 
tions and endowments. 


The 1966 winner of the ARNN bursary 
is Donna Le Drew. The $150 bursary, offered 
by the Gander Chapter of the Association 
of Registered Nurses of Newfoundland, is 
to be offered annually to a student in the 
Gander area who has been accepted at one 
of the schools of nursing. Miss Le Drew 
commenced her nursing education at the 
General Hospital, St. John's, this October. 


Louise Dupuis, in her final year at the Uni- 
versity of Ottawa School of Nursing, and 
Verna Jardine, at the University of New 
Brunswick School of Nursing, were both 
awarded the Muriel Archibald Scholarship. 
Valued at $500, this scholarship is presented 
by the New Brunswick Association of Regis- 
tered Nurses. 


Carolyn Wilson and Annette Frenette have 
been awarded NBARN scholarships of $500 
each. Miss Wilson is presently attending the 
University of New Brunswick School of 
Nursing while Miss Frenette is continuing 
her studies at the University of Moncton 
School of Nursing. 


Ethel R, Irwin has been appointed senior 
consultant in public health nursing in the 
Local Health Services Branch, Toronto. For 
two years prior to taking up her new duties, 
Miss Irwin was regional consultant in public 
health nursing, London, Ontario. 
A graduate of the Toronto General Hos- 
pital School of Nursing, Miss Irwin obtained 
her certificate in administration and super- 
vision from the University of Toronto 
School of Nursing. In 1954 she joined the 
Temiskaming Health Unit and in 1956 was 
appointed regional supervisor in Northern 
Ontario. 
Mis Irwin returned to her studies in 1957 
as a student at Teachers' College, Columbia 
University. She obtained her Bachelor of 
Science degree in 1961. 


Dr, Philip Banister has been appointed doc- 
tor at the Child and Maternal Health Divi- 
sion of the Department of Health and 
National Welfare. A specialist on pediatrics, 
Dr. Banister will help to complete the pub- 
lication on standards of hospital care for 
mothers and their newborn infants. He will 
also be active in preparing the first national 
conference on maternal and infant hygiene, 
which will take place next year in Ottawa. 
Born in England, Dr. Banister received 
his medical degree from Edinbourgh Uni- 
versity, Scotland. He specialized in pediatrics 
at the Montreal Children's Hospital as well 
as in the United States and Italy. D 


'-J--" 


R
 Namt Poo rJ 
Preferred by Nurses Everywhere! J # 
. i 

: No. 
j 510 


ANN COHN, loP. N. 
- OOR\ 5 V,..... 
M\SS "EM) NURSE 
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No. 
100 


\rõR. JO

\t)EN1 
,i
 
I LSON, R. N. 
-
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. f. J'.' · 
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PËR'J\SOR 
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No. 
169 


Largesl selling among nurses I Superb lifelime qua- 
lity . .. smoolh rounded edges... fealherweighl, 
lies flal. . . deeply engraved, and lacquered. Snow- 
white plastic will not yellow. Satisfaction guaran- 
leed. GROUP DISCOUNTS. " write for full color 
order envelopes, group prices. 
SMART IDEA: Order 2 idonlical (samo name) Pins 
at dilcount price., at precaution qoin.t 10.. and 
added convenience 
(I..s changing). 


With 1 line Wit" 2 lines 
lellerml lelleflnl 


1 Pin ani, .60 .90 
2 Idenllell 1.00 1.60 
1 Pin onl, 1.25 1.55 
2 Identlc
1 2.00 2.60 


R

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ap. lè 

 


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Now remove and retas. 
ten cap band instanlly 
for launder in I or 
replacement! Delicately 
melded Cap. Toes are in. 
conspicuOUs front and 
back, yet sturdy far 
years of service. 
Choose Black. Dk. Blue or Clear 
plastic with tmy gold caduceus 
mot,f. __ or Sohd Black (no gOld) 



 

 

 



 


6 
::'.$ 1 
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TO, RUYE$ COMPA"Y, AtlleÞoro. Mass. 02703 


STYLE DESIRED, No. o. .hown obove. 
METAL FINISH (169 or 100) Gold 0 Silver 0 
LETTERING COLOR, Block 0 Dark Blue 0 


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NOTE: Order for 1. '2 or 3 persons on above 
coupon. . . U5e extra sheet for more. 
"Dilleren'" fdeas for Gills and f;lvors. Too! 
THE CANADIAN NURSE 19 



{ 


A New Text! 


Kallins 
TEXTBOOI< OF 
PUBLIC HEALTH NURSING 


Here is an effective new approach to public health 
nursing. stressing usable facts and principles of 
public health rather than theory. Designed for courses 
in Public Health Nursing, this new text integrates 
essential principles of the science of public health with 
the major areas of nursing knowledge and practice. 
Precise, readily understood discussions give students 
clear, effective guidelines and principles upon which 
to base their nursing diagnosis and intervention 
for the protection of health as well as prevention of 
disease and disability. You will find up-to-the-minute 
evaluations of current solutions to such new 
public health problems as mental health, drug 
addiction, alcoholism, air pollution control, poison 
and radiation control, housing and slum situations, 
rehabilitation, control of heart disease and cancer, 
as well as nursing education. TEXTBOOK OF 
PUBLIC HEALTH NURSING sheds new light on 
the growing dimension of this specialized area of 
nursing practice and gives the student nurse a 
thorough understanding of her potential role in the 
various public health areas. You will appreciate the 
flexible design of this new text, and its adaptability to 
your individual classroom situation. 


By ETHEL L. KALLINS, R.N., B.S., M.P.H., Assistant Professor 
of Public Health and Public Health Nursing, St. Joseph College, 
Division of Nursing, Emmitsburg, Maryland. Publication date: 
January, 1967. Approx. 375 pages, 6Yz" x 9Yz", 57 illustrations. 
About $8.10. 
20 THE CANADIAN NURSE 


1
we · 


lf6" fPttJ' 
wid a ð4 


tIteVt 
 


tie fUVU 


New 2nd Edition! 


Heckel-Jordan 
PSYCHOLOGY 
The Nurse and the Patient 


The new 2nd edition of this stimulating textbc 
has been revised and updated to give the nurs, 
a working knowledge of psychology so that sl 
in turn, can deal more effectively with the mar 
of patients she encounters. This text can hell 
students clearly see the importance of psychol 
in achieving satisfactory nurse-patient relation 
Designed for basic courses in psychology in b( 
diploma and degree programs in Schools of 
Professional Nursing, this new 2nd edition ha
 
carefully revised to provide a completely curn 
in-depth presentation of general psychology æ 
relates to the field of nursing. Extremely read 
easy to understand, this new edition can help 1 
student relate psychological principles to her ( 
experiences as a student, as a nurse and as a p 
This edition examines its subject in greater de 
than the previous edition and includes all tht 
views and concepts. An entirely new chapter 
on sensation can provide your students with a 
understanding of this subject. 


By ROBERT V. HECKEL, B.S., M.S., Ph.D., Professor of F 
Director of Clinical Training, and Director of the Psycho" 
Services Center, University of Soutt: Carolina, Columb 
and ROSE M. JORDAN, B.S., R.N., Supervision of In-Sen 
Education, Gracewood State School and Hospital, Gracey, 
Publication date: January, 1967. 2nd edition, approx. 36 
6Yz" x 9Yz", 88 illustrations. Price, $8.10. 


JANUARY 1967 




 texú tð Iedp 
11t
 
d
þt 


New Book! 
;h- Wagner 
JRI<BOOI< FOR 
NECOlOGIC NURSING 


ynecologic disorders, many underlying 
hological factors are more disturbing to 
>atient than the fact her physical health is 
ted. This new workbook assists the 

nt nurse in becoming aware of this 
donal involvement and in learning how 
, explanation is within the scope of 
ing care. Giving close attention to both 
heory and clinical experiences involved in 
cologic nursing. the authors specifically 
s the equal importance of student 
vledge of reproductive anatomy and 
iology, and their awareness of the 
'nt's emotional involvement. 
eeding from the basic to the clinical, 
workbook explains the anatomy and 
iology of the female reproductive organs, 
describes puberty, the gynecologic 
lination and the nurse in the clinic, 
"ders of menstruation, functional and 
unctional bleeding. and the menopause. 
mg its timely discussions are those 
acterizing genital anomalies, gynecologic 
lems in marriage, pelvic inflammatory 
ise. and neoplasms of the uterus 
ovaries. 
flexible design of this workbook makes it 
ly suited for use with any required text 
select. Perforated, punched pages 
v removal of completed assignments for 
ing and accumulation in a ring binder 
uture reference. Self-examination tests 
ncluded and a separate, 20 page answer 

 is provided for the instructor. 


)NSTANCE lERCH, R.N., B.S., (Ed.); and JOANNE 

GNER, R.N., B.S. (Nurs.). Publication date: 
'ry, 1967. Approx. 130 pages, 7 1 "" x 10%", 
rated, perforated and punched. About $3.80. 


New 7th Edition! 
Jessee 


SELF-TEACHING TESTS 
IN ARITHMETIC FOR NURSES 


Here is a simple, direct approach to basic arithmetic 
and its application to problems in dosages and solutions. 
Flexibly designed for use as either a self-teaching text 
or for classroom instruction, this book can help your 
student develop sufficient knowledge and skill in arithmetic 
so that she can learn to safely administer medications 
in the proper dosage. To bring it into closer conformity 
with modern mathematics, this new edition has been 
rewritten and expanded to incorporate new information 
and changes in terminology. 
This new edition has been designed with perforated, 
punched pages that can be easily removed from the text, 
handed in and/or kept in a separate book or folder. 
The achievement tests have been printed on separate pages 
so that, if desired, you can use them in evaluating the 
progress of your students. You will also appreciate 
the convenience of the separate answer book, provided 
with each copy at no additional cost. 


By RUTH W. JESSEE, R.N., Ed.D., Chairman, Department of Nursing 
Education, Wilkes College, Wilkes-Barre, Pennsylvania. Publication date: 
March, 1967. 7th edition, approx. 164 pages, 7 1 "" x 10%", 
21 illustrations. About $3.25. 


New 4th Edition! 
Price 


A HANDBOOI< AND CHARTING 
MANUAL FOR STUDENT NURSES 


This unique handbook is ideally suited to (1) help the 
student applicant prepare herself to meet scholastic 
requirements for admission to schools of nursing and 
(2) to assist the beginning student who experiences 
difficulty with one or more of the courses she is taking. 
It is used as a self help handbook or as a required test. 
This book can help you give your students the additional 
help they may need in arithmetic, spelling, vocabulary, 
study habits and reading with comprehension, handwriting 
and printing, and personal appearance. An important 
feature of this workbook is the well written and highly 
understandable presentation of the fundamentals of 
charting. This section has been revised and updated 
in this edition to give the student the latest accepted 
methods and concepts of charting. 


By ALICE l. PRICE, R.N., M.A. Publication date: January, 1967. 
4th edition, approx. 220 pages, 8%" x 11", 50 illustrations. 
About $5.30. 


HE C. V. MOSBY COMPANY, LTD. 
 Publishers 
86 Northline Road. Toronto 16, Ontario 
 


JANUARY 1967 


THE CANADIAN NURSE 21 



new products 


{ 


Descriptions are based on information 
supplied by the manufacturer and are 
provided only as a service to readers. 


Benoxyl Lotion 
(WINLEY-MORRIS) 
Description - A locally effective agent for 
the treatment of acne. Benoxyl lotion is a 
stable preparation of Benzoyl Peroxide 5% 
in a unique, greaseless, washable lotion base. 
Indications - In the treatment of acne 
vulgaris as an antibacterial and mild kera- 
tolytic agent. 
Administration - Cleanse skin with a mild 
soap such as Acne-Aid detergent soap. Ap- 
ply Benoxyl Lotion to affected areas with 
fingertips and smooth in gently according 
to the following schedule: first 4 days: 
apply once daily, leave on for 2 hours, then 
remove with warm water; next 4 days: apply 
once daily, leave on for 4 hours, then re- 
move; next three days: leave on overnight: 
ultimately: apply after each washing. 
Benoxyl is completely invisible on the 
skin. It should be stored in a cool dark 
place but not frozen. 
Caution - Benoxyl is for external use 
only and should be kept away from eyes, 
mucous membranes and sensitive areas of 
the neck. Should excessive drying or irrita- 
tion occur, use should be discontinued tem- 
porarily. 


Disposable Toothbrush 
(VENDEX) 
Description - An entirely new disposable 
toothbrush with its own buh-in dentifrice. 
Developed by Du Pont, this nylon bristle 
brush. to be distributed exclusively through 
vending machines, is intended to fill a 

erious gap in the dental hygiene routine of 
people who find themselves away from 
home without their regular toothbrush or 
toothpaste. 
Bristles are coated with a water-soluble 
dentifrice which is activated when moistened 
to perform the normal cleansing and breath- 
sweetening functions of ordinary dentifrices. 
Each brush is individually packaged in a 
cellophane wrapper and is so economical it 
may be thrown away after a single use. 
Vendex International, Inc., Houston, 
Texas, which has exclusive marketing rights 
on the new product, will distribute the 
brushes only through compact coin-operated 
vending machines located in selected wash- 
rooms of clubs, restaurants, airports, mo- 
tels . .. "wherever there are active people 
on the move." Vendex distributors are being 
established in each market to serve as local 
distributors for the handling of inventory 
and servicing of the machines. 
For additional information contact: Ro- 
bert Fogle, vice president, Vendex Interna- 
tional, Inc., 4125 Richmond Avenue, Hous- 
ton, Texas. 
22 THE CANADIAN NURSE 


Infant Vascular Clamp 
(SKLAR) 
Use - A new vascular clamp designed 
by Dr. G.A. Trusler of the University of 
Toronto. The new design has proven parti- 
cularly useful in Blalock anastomisis, in the 
repair of infant coarctations, and in other 
procedures involving small vessels in chil- 
dren and infants. 


Description 
The shaft is thin 
and springy, thus, 
when fully closed, 
the clamp will 
neither slip nor in- 
jure the vessel. The 
"Z" shape of the 
jaws facilitates 
placing and tying 
of sutures. The op- 
posing jaws of the 
clamp are relatively 
flat, with a finely 
roughened surface which provides a secure 
grip, but will not split the soft intimal lining 
of the vessel. 
Descriptive literature (No. 280-190) is 
available from J. Sklar Mfg. Co. Inc., 38-04 
Woodside Avenue. Long Island City. N.Y. 
11I01. 


alv 


TR1 UR INr
T VA. I.i.R ClAMP 


6 Pak Sutures 
(THOMPSON) 
Description - Six non-absorbable sutures 
in one p.!cket in a quick-opening "book." 
This package of sterile, non-traumatic silk 

utures is convenient when a number of 

uture
 are needed quickly by the surgeon. 
The six sutures, with attached needles, are 
threaded on a paper "book" having con- 
venient end flaps. The folded book is sealed 
and irradiation sterilized in a transparent 
peelable outer envelope. The nurse or as- 
sistant merely pulls the end flaps to open 
the book and the sutures are ready for 
instant use. 
R. H. Thompson Laboratories Ltd., an 
all-Canadian firm, developed this new "6 
Pak." Further information may be obtained 
by writing the Laboratorie
 in Don Mills. 
Ontario. 


Acne Aid Cream 
(WINLEY-MORRIS) 
Description - A flesh-colored. greaseles
 
agent with water-washable base for the treat- 
ment of acne. Acne-Aid cream is composed 
of 2.5% sulfur, 1.25% resorcinol. .625% 
hexachlorophene and .375% para meta 
chloroxylenol. 
Indications - In acne vulgaris, and where 
a mild keratolytic, anti-seborrheic and anti- 
microbial agent is required. 


Administration - Wash the affected part 
with whatever special cleanser is recom- 
mended by the doctor. Dry thoroughly 
without rubbing. Apply Acne-Aid Cream 
with the fingertips. allowing a thin film to 
remain. 
Caution - Keep away from eyes and off 
eyelids. Should excessive dryness or irrita- 
tion develop, discontinue use temporarily. 


Uroscreen Test 
(PFIZER) 
Description - A simple, convenient. rapid 
and reliable screening test. standardized for 
the detection of significant bacteriuria 
(100.000 or more organi
ms per ml. of 
urine) Uroscreen i
 a white. dry, stable, 
soluble. buffered tetrazolium reagent (2, 3. 
5 triphenyl tetrazolium chloride). 
Indications - The presence of significant 
bacteriuria is indicated by the formation of 
a pink to red precipitate - indicating a pos- 
itive uroscreen test. No precipitate or a 
colorless precipitate shows a negative uro- 
screen test. 
Procedure I. Collect urille: e3rly 
morning specimen is preferable. Collect the 
"midstream" specimen from men and the 
"clean-catch" specimen from women. If the 
test cannot be performed within 2 hour
 
after collection, the specimen 
hould be 
stored, below 10 0 C. up to 24 hours before 
uroscreen testing. 2. Add to um.Kreen: Shake 
urine specimen until any precipitate is 
uniformly suspended. Add 2ml. of urine to 
the uroscreen tube, which is marked at the 
2 ml. level. Shake well until the uroscreen 
reagent is completely dissolved. 3. Incubate: 
Incubate at 37 0 C for 4 hours in the Uro- 
screen dry-bath incubato- or other suitable 
type. rmportant: do not shake or disturb the 
uroscreen tube during incubation. If the 
precipitate is disturbed before the reading, 
the resuspended precipitate mu
t be centri- 
fuged or the test repeated. 4. Read re.llllt.\: A 
positive uro<;creen test (pink to red precipi- 
tate) is indicative of the presence of 
ignifi- 
cant bacteriuria and calls for detailed bac- 
teriological examination of the urine. Highly 
infected urines may give a red precipitate 
within I or 2 hours imd also show a red 
turbidity throughout the urine. A pink to 
red color, without precipitate. is negative; 
a precipitate of any other color is also 
negative. 
Uro
creen is pre
ented in boxes of 50 
te
t tubes. ready to use. A special dry-bath 
incubator is available free of charge with 
initial orders of 100 tubes or more. 
For further information on Uroscreen and 
urinary tract infections, contact Pfizer Com- 
pany Ltd., 50, Place Cremazie, Montreal II. 
JANUARY 1%7 



dates 


] 


January 9-11, 1967 
Second Educational Assembly on 
Hospital Administration, District Eight, 
Fort Garry Hotel, Winnipeg. 
January 11-13 and January 16-18, 1967 
Institute for Supervisors, Ramada Inn, 
Vancouver, B.C. 
Open to all nurses working as 
supervisors or to head nurses who 
assume supervisory functions. 
Details may be obtained from the 
Registered Nurses' Association of B.C. 


January 24-26, 1967 
Institute on Outpatient Department 
Nursing Service Management, 
Bellevue Stratford Hospital, 
Philadelphia, Penna. 
February 6-9, 1967 
Four-day conference on staff education 
and staff development. Sponsored by 
RNAO, OHA, OMA, OPHA, OHSC, 
Westbury Hotel, Toronto. 
February 19-23 
14th Annual Association of 
Operating Room Nurses' Congress. 
EI Cortez and U.S. Grant Hotels 
San Diego, California. 
For information write 151 East 50th 
St., New York City or Miss Nellie 
Mock, 458 "F" St., Chula Vista, 
California. 


End of March 
Institutes for Instructors, Ramada Inn, 
Vancouver, B.C. 
A two-day institute sponsored by the 
Registered Nurses' Association of B.C. 
April 28 - October 27, 1967 
Expo '67, Montreal. 
May 4-6, 1967 
St. Boniface Hospital, School of 
Nursing, 25th Reunion of the 1942 
graduating class. Would members of 
the 1942 graduating class please 
write to Miss F.E. Taylor, R.N., 
10123 - 122 Street, Edmonton. 
May 8-12, 1967 
National league for Nursing, Biennial 
Convention, New York. 


May 10-12, 1967 
Canadian Hospital Association, 
Montreal, P.Q. 
May 16-19, 1967 
Alberta Association of Registered 
Nurses Annual Meeting, Chateau 
lacombe, Edmonton, Alberta. 
JANUARY 1967 


May 24-26, 1967 
International symposium on electrical 
activity of the heart, london, Ontario. 
For further information, write to 
Dr. G.W. Manning, Victoria Hospital, 
london, Onto 
May 31 - June 2, 1967 
Registered Nurses' Association of 
Nova Scotia Annual Meeting, Sydney, 
N. S. 


May 31 - June 2, 1967 
Registered Nurses' Association of 
British Columbia Annual Meeting, 
Bayshore Inn, Vancouver, B.C. 


June 12-15, 1967 
Canadian Dietetic Association 32nd 
Convention, Château laurier, Ottawa. 


June 18-21, 1967 
Ottawa Civic Hospital, Centennial 
Home Coming. 
Alumnae or former associates of the 
Ottawa Civic Hospital who are 
interested in the Program should write 
to: Executive Director, Ottawa Civic 
Hospital. 
June 24, 1967 
St. Joseph's Hospital, Toronto, School 
of Nursing, Centennial Reunion. 
Any graduates who do not receive 
alumnae newsletters, please send 
name and address to: St. Joseph's 
Hospital, School of Nursing Alumnae, 
30 The Queensway, Toronto 3, 
Ontario. 


July, 1967 
75th Anniversary, Nova Scotia 
Hospital School of Nursing, Dartmouth, 
N.S. 
All interested graduates please 
contact Mrs. G. Varheff, 20 Ellenvale 
Ave., Dartmouth, N.S. 
July 31 - August 4, 1967 
The annual Medical Equipment 
Display and Conference (Medac '67). 
Sponsored by the Association for the 
advancement of medical instrumenta- 
tion (AAMI), San Francisco Hilton 
Hotel. For information write: 
AAMI, P.O. Box 314, Harvard Square, 
Cambridge, Massachusetts 02138. 
Sept. 15-17, 1967 
70th Anniversary, Aberdeen Hospital 
School of Nursing, New Glasgow, 
Nova Scotia. Those interested write: 
Mrs. Allison MacCulioch, R.R. #2, 
New Glasgow, Pictou Co., 
Nova Scotia. 


MOVING 


? 


. 


DON'T FORGET YOUR 
CHANGE OF ADDRESS 


Name: 


Registration No.: 
(If registered in two provinces. 
please give both.) 


Province: 


Old Address: 


New Address: 


Date effective: 


Allow at least six weeks 
for change of address 


Mail to: 


The Canadian Nurse 
50 the Driveway 
Ottawa 4, Onto 


THE CANADIAN NURSE 23 



No one ever said it would be easy. 


running a hospital with a minimum of profit. Unless you count it profitable to see 
medical supplies - building a bridge with developing nations master new skills and 
nothing but timber and sweat - teaching a new standards of health and science. 
child who knows only a strange tongue. But You can't earn a promotion. . . but you can 
that's what CUSO workers do . . . hundreds promote. You will promote new learning, and 
of them in 35 countries. They meet the chal- enthusiasm, and a desire to succeed in 
lenge of a world of inequalities - in educa- people who are eager to help themselves. 
tion, in technical facilities, in engineering There are no Christmas bonuses. . . but you 
and medicine. earn a bonus every day in the response of 
This year, the Canadian University Service the people you work and live with. And you'll 
Overseas - a non-profit non-government be amazed at how quickly you'll find an op- 
organization - has already sent 350 young portunity to develop your ideas, your dreams. 
volunteers to countries in Asia, in Africa, Willing to work to build a better world? 
South America and the Caribbean. . a .. Here's just the job for you. 
total of 550 CUSO people altogether in A.
-: How do you apply? Get more informa- 
the field, or about 1 to every 50,000 . . .;' tion and application forms from local 
people who ask for their help. More. CUSO representatives at any Canadian 
are needed. university, or from the Executive Sec- 
The pay is low. . . you won't make a retary of CUSO. 151 Slater St., Ottawa. 


cuso 


The Canadian Peace Corps 


24 THE CANADIAN NURSE 


JANUARY 1967 



"Wallted - a revised Itlcome Tax Act 
that recognizes the role of married 
women in the labor force." 


This is what over one million work- 
ing women - and their husbands - 
will yearn for when they compile their 
annual income tax forms early in 1967. 
For the present income tax structure 
is geared to a Victorian society where 
only the man of the family was employ- 
ed and the woman stayed home as a 
dependent. 


Husband no longer sole breadwinner 
According to 1965 data from the 
Special Surveys Division, Dominion 
Bureau of Statistics, the number of 
working women in this country is now 
over 2 million. This represents 30 

rcent of the total work force. 
Prior to 1960, single women out- 
ranked married women in the labor 
force. Since 1960, however, married 
women have maintained first rank in 
the percentage distribution by marital 
status. Their percentage passed the 
half-way mark in 1964. and now stands 
at 52.2. 
That these married women play an 
essential role in our economy is un- 
deniable. That the large number of 
married women who are presently un- 
employed would be valuable recruits 
to the labor force is also undeniable. 
except by those few who still maintain 
that the woman's place belongs only 
at the hearth. 


Needed changes in tax structure 
The major changes that are needed 
to bring income tax regulations up-to- 
date with the manpower structure in 
Canada were brought to the attention 
of the House of Commons this past 
June, by Mrs. Grace MacInnis, Mem- 
ber of Parliament for Vancouver- 
Kingsway, B.c. 
Mrs. MacInnis said that the amount 
a married woman is allowed to earn 
before deductions are made from her 
husband's taxable income ($250), is 
far too low. considering today's cost 
of living. She pointed out that various 
organizations across the country have 
JANUARY 1967 


EDITORIAL 


requested that it be raised. The Can- 
adian Federation of University Women, 
for example, have urged that the 
amount be increased to $950. 
The second change in taxation 
policy proposed by Mrs. MacInnis, in- 
volved the expenses of housekeeping 
and babysitting services. She recom- 
mended that the wages of housekeepers 
should be deductible from the taxable 
incomes of mothers working outside 
the home. In defence of her proposal 
she said: 
"It is no use telling us that .it is 
all very well for lawyers and business- 
men to deduct necessary expenses, but 
that it is quite another matter for a 
woman working outside the home to 
ask for the right to make the same 
sort of deductions. The expenditure is 
just as necessary. In fact, it is more 
necessary because it has been esta- 
blished . .. that the vast majority of 
women who go to work. . . do so from 
economic necessity, and there is no 
question of their being able to meet 
the costs of a housekeeper from out- 
side earnings." 
In an earlier speech in the House of 
Commons, Mrs. MacInnis questioned 
the incongruity of a law that calls a 
working woman who employs a house- 
keeper an "employer" - and requires 
her to contribute to the housekeeper's 
Canada Pension Plan - yet refuses to 
call her an employer under the Income 
Tax Act, thereby disallowing any de- 
ductions of housekeeper expenses. 


Taxation in other countries 
In certain countries, such as the 
United States of America and the 
United Kingdom, the tax position for 
married women is quite favorable. 
In the United States, for example, a 
working wife can deduct up to $900 
for child care expenses when there are 
two or more children, or $600 for one 
child. The stipulations are that the 
child be no more than 12 years old, 
and that the joint income of the parents 
not exceed $6,000. 
In the United Kingdom, preference 
is given to working married women: 
they get a single person's tax-free al- 


lowance for earnings, in addition to 
t
e husband benefiting from the mar- 
ned man's allowance, which is nearly 
double the single person's.* 
The tax structures in a few coun- 
tries, on the other hand, appear to be 
intended to discourage the wives of 
all but the neediest of husbands from 
employment. In the Netherlands, for 
example, a married woman's earnings 
are taxed 15 percent if she is not the 
breadwinner. ** 
Nurses effected 
What effect does this out-dated IIl- 
come tax act have on nurses? 
For single nurses, it has little effect 
at this time; however, a few years from 
now many of these nurses will have 
assumed the role of wife, and possibly, 
mother. If the present trend toward 
employment continues - and there is 
every reason to believe it will - they 
will be among those affected by these 
discriminatory tax policies. 
For married nurses, who represent 
60 percent of all nurses employed full- 
time, these tax policies must be frus- 
trating, costly, and discouraging. That 
these nurses continue to work in spite 
of them is proof of their desire to 
remain active in the profession. 
For the 19,781 married nurses listed 
as "not employed in nursing" in 1965, 
the present income tax policies un- 
doubtedly discourage re-employment. 
The return of even a portion of these 
women to active nursing would do 
much to offset the critical shortage of 
nurses throughout the country. 
Conclusion 
For those married nurses already 
working, and for those who represent 
a large, untapped source of manpower. 
revisions of the Income Tax Act would 
mean one less obstacle in the path to 
employment. 
If we speak loudly enough, in 
unison, Canada will listen. 


* Viola Klein. Women Workers - Working 
Hours and Services. Paris. Organization for 
Economic Co-operation and Development. 
1965. 
** Ibid. 


THE CANADIAN NURSE 25 



Habilitation of thalidomide 
children: the nursing approach 


Most of the children suffering from 
congenital deformities as a result of 
thalidomide were hospitalized during 
their first year of life. At this stage, 
the nurse's role was largely custodial. 
The nursing problems of these chil- 
dren - skin care, sitting balance, and 
protection from injury - differed from 
those of normal children. 
As the children started to grow, 
however, the nurse had to re-examine 
her role. How could the basic concept 
of rehabilitation - the return of the 
patient to a meaningful role in society 
- be applied to these children who 
had little or no idea of the outside 
world? 
Several of these children were still 
hospitalized at two years of age. The 
difference in development between 
them and the children who had the 
advantages of normal home life was 
apparent. It was pinpointed by the 
work of our colleagues in psychology. 
whose findings made it eviòent that 
something had to be done to provide 
the hospitalized children with some 
of the advantagcs and stimulation of 
a domestic environment. 
The first problem involved the num- 
ber of persons coming in contact with 
the children. A stuòy by the hospital's 
social service department showed that 
each child had a minimum of 43 con- 
tacts each day: nurses, doctors, thera- 
pists, volunteers, nonprofessional staff, 
patients, and visitors. Further, because 
of the rotation system, the nurses car- 
ing for the children changed two or 
26 THE CANADIAN NURSE 


How do thalidomide children react to the outside world after a prolonged 
hospitalization and what type of help do they need to adjust to it? A team at the 
Rehabilitation Institute of Montreal attempted to answer these questions. 


Mary O'Brien, R.N., Margaret Owens, R.N., and 'an Ralph, R.N. 


three times each week. 
Several steps were taken to solve 
these problems. First, a "baby-team," 
consisting of two registered nurses and 
one licensed nursing assistant, was set 
up. The team leader was a nurse with 
pediatric training and a great deal of 
experience. The second R.N. was the 
mother of a two-year-old. The nursing 
assistant was a young married woman 
who had shown special aptitude in 
caring for children. Two nursing as- 
sistants were assigned especially for 
evening duty. 
This team. under the supervision of 
the head nurse, took over the complete 
care of the children. The arrangement 
demanded some sacrifice from the 
other staff in the unit. Since the babv 
team did not rotate, the other staff 
had to do more tours on shift duty; 
also, those not assigned to care for the 
children regretted the loss of contact 
with a most lovable group of patients. 
However, after an explanation by the 
director of nursing. they accepted these 
arrangements. Similarly, the volunteers 
cheerfully agreed to confine their at- 
tentions to the older children. 
The head nurse then re-examined 
the phvsical setup of the ward. In- 
stead of occupying six small rooms - 
four for sleeping, one for eating, and 


Miss O'Brien was director of nur
ing at 
the Rehabilitation Institute of Montreal. 
Mi
s Owen
 i
 head nurse on the pediatric 
unit, amI Mi

 Ralph i
 the team leader 
of the "baby team" formed at the rn
titute. 


one for playing - the children took 
over two large units - one for sleep- 
ing, the other for eating and playing. 
This had many advantages: 1. The 
children seemed more secure and less 
confined within a larger, definite area. 
They were out of the way of other 
patients, wheelchairs and corridor traf- 
fic; 2. The rooms (23 feet x 17 1/2 
feet) were near the nursing station, so 
that observation was constant; 3. Bet- 
ter cross-ventilation was possible and 
it was easier to maintain a constant 
room temperature; 4. The children's 
toys and equipment were more ade- 
quately controlled and were safe from 
the raids of older children. 
At this point, the baby team dis- 
carded their uniforms in favor of street 
clothing. This proved very successful. 
The children were encouraged to call 
the baby team nurses by their Christian 
names. There were two reasons for 
this. The children's speech develop- 
ment was slow and it did not seem 
reasonable to expect a child whose 
first words would normally be "mama" 
or "papa", to substitute "Miss Ralph" 
or "Madame RousseL" Further, at two 
to three years of age, the children were 
not identifying individuals. As they 
were mostly French-speaking, everyone 
was "ma tante." By using Christian 
names, the children found it easier to 
identify the nurses, and their "aunts" 
became special rather than general. 
The next step was to introduce the 
children to the outside world. Outings 
were initiated at such times as they 
JANUARY 1967 



.} 


JANUARY 1967 



_. 



 


The clothing requirements of children 
with deformities are complex. The staff 
at the Rehabilitation Institute of 
Montreal developed several functional 
garments for the children with 
prostheses, including the dress and 
panties shown in photograph. 


. 


" 


. 


\ 


could be coordinated with prosthetic 
training. Small groups were taken to 
visit the zoo, the circus, shopping cen- 
ters, Santa Claus, and to eat lunch 
in a restaurant. They had picnics and 
train rides and were taken skating in 
a public park. When the children were 
from three-and-one-half to four-years- 
old, our physiotherapy department 
began teaching them to swim; their 
daily sessions in the pool are now a 
high spot. 
The baby team nurses also took the 
children to their own homes for lunch. 
On these visits the children appreciated 
seeing things they did not see in the 
Institute: design and - color of food; 
china and tablecloths; shower curtains; 
door knobs, and carpets. We have tried 
to introduce as many of these as pos- 
sible to the Institute. 
The result of these outings was ex- 
tremely satisfying. The most with- 
drawn child became quite relaxed 
about new human contacts. The reac- 
tion of the general public was also 
encouraging. Apart from an occasional 
stare and a few questions from mothers 
with children of the same age, we met 
only kindly interest and offers of help. 
From the outings the children de- 
veloped interest in dressing and wear- 
ing pretty clothes. We made no attempt 
to hide prostheses, but tried to dress 
the children as much as possible like 
children their own age. They now 
have very definite likes and dislikes in 
color, and we have tried to make them 
feel that the garments they prefer are 
THE CANADIAN NURSE 27 


r 


1 



The hospitalized children now occupy 
two large units - one for sleeping, 
the other for eating and playing. 


Daily swimming sessions in the pool 
are a high spot for the children. 


...... 
- .............. _ rII-- 


---- 


their own and not communal. 
The clothing requirements of chil- 
dren with deformities are complex. As 
so many people are involved, the baby 
team leader has been given the addi- 
tional assignment of coordinating the 
needs and ideas of occupational thera- 
pist, parents, nurses and volunteers. 
Much thought was given to the de- 
sign of garments to be worn over pros- 
theses, especially those of the upper 
extremities. After consultation with 
nurses, occupational therapists, psy- 
chologists, and a group of ladies who 
kindly offered to sew for us, we have 
evolved several functional garments 
that are also attractive. Velcro clos- 
ures have been used instead of but- 
tons, but the illusion has been pre- 
served by sewing buttons in place. 
Since we found that the action of 
cables quickly wore through materials, 
we have used iron-on patches inside 
shirts and in dresses across the shoul- 
ders. The velcro can be opened and 
closed with the prosthesis or feet, thus 
making the child as independent as 
possible in dressing and undressing. 
One attractive but useful dress has 
velcro closures down the back. It is 
sleeveless with separate sleeves (in a 
white or contrasting color) which can 
be attached with velcro inside around 
the armhole. For most activities the 
child can use the prosthesis without 
sleeves; for dress-up occasions the 
sleeves are easily attached. 
Toilet independence has presented 
many problems because of the chil- 
28 THE CANADIAN NURSE 


I 
,
 


)- 
. 



 


\ 
 

 
. 


- 
'"----- 



 


- 



, 


.. 


, 



 - 




" 


- 
., 


- 


dren's prostheses and lack of upper 
extremities. Panties have been designed 
on a diaper principle, with strips of 
velcro down each side substituting for 
safety pins. The diaper is held around 
the waist by an attached band of ma- 
terial. To remove the flap of the pan- 
ties for toilet purposes, the front flap 
can be pulled down with the child's 
prosthesis or fingers inserted in a loop 
made of tape on either upper front 
corner of the diaper . To replace the 
flap of the panties, the child sits down 
on the diaper and raises the flap using 
the loops to pull it up into position. 
Then he stands up and presses his hips 
against the wall to fasten the velcro 
securely. One of our mothers devised 
a method of pulling panties up and 
down with tapes and attaching them 
with velcro, but this method still re- 
quires further thought and develop- 
ment. 
It is interesting to note how the 
concept of the "rehabilitation team" is 
applied to the thalidomide group of 
children. Every week the baby team 
has held a meeting led by the con- 
sultant in psychology. Her advice on 
the management of individual children 
and general problems has been inval- 
uable. Since the nurse and occupational 
therapist must work together in pros- 
thetic training, the occupational thera- 
pist in charge of the children also at- 
tended these meetings. From the meet- 
ings a most rewarding relationship 
with social service developed, which 
has since expanded beyond this group 


- 


òii;: 


of children to all age groups in the 
unit. Our colleagues in speech therapy 
who attended these meetings outlined 
the normal development of speech and 
pointed out specific difficulties with 
various children. The department of 
therapeutic recreation helped us with 
outings. Volunteers have been very 
valuable. In fact, the whole operation 
has been a real team effort, under 
the benign supervision of the chief of 
service. 
Now the children are all in their 
own homes or foster homes. We hope 
that we have made their adjustment a 
little easier. Certainly congenitally mal- 
formed children who come to us in 
future will pre.sent fewer problems to 
the nursing department in the light 
of this unique experience. D 


JANUARY 1967 



Impact of cerebral palsy on 
patient and family 


What must parents face when told 
that their child has cerebral palsy? 
They must face the fact that the con- 
dition cannot be cured by medical or 
surgical procedures and that the effects 
of the disease will persist throughout 
the life of the individual. They must 
realize that the disease may limit 
education and employability, marriage 
and the bearing of children, self- 
sufficiency, and self -support. Although 
these limitations are modifiable through 
therapy, the parents will have to invest 
a considerable amount of time and 
money in the therapeutic program. 
This program will change the normal 
routines of the home and will, of 
necessity, create an extremely close 
relationship between the parents and 
their handicapped child. 
Some parents will have to face the 
fact that their child has additional de- 
fects, such as mental retardation, deaf- 
ness, aphasia, and convulsions, with 
all their inherent problems. 
The impact of the diagnosis on the 
family is tremendous, and the inter- 
view during which the parents are 
confronted with this diagnosis is ex- 
tremely traumatic. 


Problems unique to cerebral palsy 
The diagnosis of cerebral palsy is 
usually made after months of anxiety. 
Frequently, the parents have been dis- 
turbed by a number of different and 
conflicting diagnoses including, in most 
cases, that of mental retardation. This 
delay is less frequent in recent years, 
JANUARY 1967 


Feelings of inferiority on the part of the patient, jealousy on the part of the 
siblings, and guilt on the part of parents, are common reactions to this disease. 


William A. Hawke, M.D., F,R.C.P. (Lond.) , F.R.C.P. (C) 


however, since physicians are becom- 
ing more skilled in diagnosing cerebral 
palsy in young children, and are be- 
coming more cautious in diagnosing 
mental retardation. 
The parents of cerebral palsied 
children affect each other both indi- 
vidually and in groups. These relation- 
ships are usually beneficial. Parents 
provide each other with additional 
information about the disease and 
about techniques that they have found 
to be effective. In many instances they 
support each other. On occasion, 
however, the effects may not be so 
satisfactory. Some parents make others, 
who plan to place their severely handi- 
capped children in institutions, feel 
that they are inadequate parents who 
are shirking their responsibilities. Oc- 
casionally, certain parents may make 
it difficult for other parents to accept 
the reality of the situation, the limita- 
tions of therapy, and the ultimate 
future. These effects, however, seem 
to be less frequent at the present time, 
probably because families have a 
closer relationship with treatment cen- 
ters, particularly with social workers 
in these centers. 
The staff of the treatment centers 
may create problems for the parents. 
Occasionally they give a poor prog- 
nosis, which is unwarranted. More 


Dr. Hawke is Professor of Pediatrics, 
University of Toronto, and Director of the 
Neurological and Psychiatric Services of 
The Hospital for Sick Children. Toronto. 


frequently, however, they create opti- 
mism in the parents because of an un- 
justifiably euphoric prognosis. 
There are several reasons for this 
over optimism. First, staff members are 
sympathetic to the parents and do not 
wish to make them face unpleasant 
realities. Second, certain members of 
the staff may lack experience and 
have not followed the progress of such 
children for sufficient time to learn 
the natural course of the disease. In 
most cases, however, the staff and fam- 
ily become involved in a personal 
struggle against the disease, and in 
this struggle the staff member loses 
his or her objectivity. Fortunately, 
these effects are less prominent at pres- 
ent because most clinics now have 
conferences in which the child's his- 
tory is presented to the staff for dis- 
cussion. 
These are only a few of the prob- 
lems that may be considered specific 
to cerebral palsy. They are, however, 
the most frequently occurring prob- 
lems. 


Effect on parents 
Feelings of anxiety may develop in 
the parents, particularly if the disease 
is severe and the prognosis grave. In 
one extreme case of anxiety reported 
several years ago, two elderly per- 
sons killed their only son who had 
cerebral palsy, since they felt that they 
no longer could give him adequate 
care. They killed him rather than let 
him go to an institution where they 
THE CANADIAN NURSE 29 



believed he would be given inadequate 
and impersonal care. 
A feeling of anger is also a com- 
mon reaction of parents. In most 
cases the anger is originally directed 
against fate. "Why did this have to 
happen to me and my child?" It is 
seldom directed against the child, but 
is projected on other individuals. 
Parents may project this free-floating 
anger toward the physician, blaming 
him because they believe the disease 
was due to improper delivery or to 
inadequate care during pregnancy be- 
cause the condition was originally mis- 
diagnosed. They may project this 
anger toward the physician because he 
is unable to cure the disease. This 
hostility is sometimes directed against 
neighbors, or even strangers on the 
street. Curiosity on the part of such 
individuals may be considered by the 
parents as evidence that they regard 
the child as a freak. 
Feelings of guilt frequently are 
evidenced by parents. If there has been 
a similar condition in the family, they 
feel responsible for transmission of the 
disease. They may feel responsible 
for the child's cerebral palsy for a 
number of reasons: Mothers who have 
not followed the prescribed regimen 
during pregnancy may believe that 
their negligence is responsible for the 
condition. In a certain number of 
cases, the pregnancy was unwanted, 
and the mothers carried out a number 
of simple activities, such as long walks, 
hot and cold baths, etc., in the hope 
that these would produce an abortion. 
If the child is born with a defect, the 
parents feel that these attempts at 
abortion have been responsible for the 
defect. Other parents of a handicapped 
child may feel that this has been their 
punishment for past misdemeanors, 
often sexual in nature. 
Feelings of denial may be part of 
the parents' pattern of defence. It is 
very difficult for parents to deny the 
cerebral palsy, but many deny the 
prognosis, accepting the realities of the 
present disability, but not ')f the future. 
These parents frequently travel from 
clinic to clinic, hoping to find someone 
who will justify their opinions. 
30 THE CANADIAN NURSE 


Feelings of rejection may occur be- 
cause of the unusual appearance of the 
child, because of the additional burden 
imposed on the family, and, in some 
cases, because the individual is unable 
to accept the fact that a child of his 
can be incomplete or inadequate. Open 
and frank rejection of the child is 
uncommon. Such feelings are usually 
intolerable to the parents and are re- 
placed by feelings of oversolicitude and 
overprotection. 
Not all overprotection is a compen- 
sation for rejection. It may simply be 
the reaction of very affectionate 
parents who feel sorry for their 
handicapped child. An extreme exam- 
ple of overprotection was the mother 
of the epileptic child who would not 
allow her daughter to cross the road 
for fear that she might have a seizure. 
This mother went to school with the 
child, returned with her, and stood 
at the window in her home during the 
rest of the day to see that she was 
not on the road. The mother of a 14- 
year-old diabetic boy who had noc- 
turnal reactions, slept with him so 
that she could detect any reactions 
that developed. 


Effect on siblings 
Usually the brothers and sisters of 
the cerebral palsied child feel pity for 
him, particularly if he is younger. They 
feel sorry for him because his activities 
are so restricted and because he can- 
not join other children of his age in 
various games and sports. 
With time, however, these feelings 
of pity often change. Jealousy may 
develop because of the amount of 
attention given by the parents to the 
handicapped child. In some homes the 
normal children are almost neglected, 
and the parents focus their attention 
on the handicapped child. Jealousy is 
particularly marked if the sibling is 
close in age to that of the handicapped 
child, and also if he is of the same sex. 
Feelings of guilt may arise in the 
sibling. In many cases these develop 
because he becomes disturbed about 
his feelings of jealousy. He feels it is 
wrong, almost "sinful," to have such 
feelings about the brother or sister 


who is so handicapped and whose life 
is so limited. 
If the parents are able to accept the 
child, so will the siblings. Large fa- 
milies seem to be able to accept the 
handicapped child better than small 
families. Rural families appear able to 
accept them more adequately than 
urban families. This sensitivity seems 
to come to a peak during adolescence 
and early adult life. It is particularly 
evident in girls who think of marriage 
and who are concerned about the im- 
pact of the handicapped child on their 
future husbands. A number are also 
concerned about the possibility of 
having similarly handicaped children 
of their own. 


Effect on handicapped individual 
As the child grows older, the effects 
of his handicap increase and are most 
marked in adolescence and early adult 
life. 
The cerebral palsied child may de- 
velop feelings of inadequacy or inferi- 
ority because of his inability to take 
part in normal activities, because of 
his physical appearance, or because of 
the limitations imposed on him by the 
treatment of the disease. In addition, 
he may experience a sense of isolation. 
This, to some degree, depends upon 
his inherited personality, but also upon 
his opportunities for contact with other 
children. Some children remain socially 
and emotionally immature because of 
restricted experiences and restricted 
contacts with normal children. 
Anger may be directed against the 
limitations imposed by the disease, or 
may be projected on others. It is often 
projected on the normal siblings be- 
cause they have a life that is richer 
and fuller. Occasionally this hostility 
may be projected against the mother, 
whom the child blames for the disease. 
Feelings of anxiety and insecurity 
are particularly evident in older child- 
ren who are handicapped. These feel- 
ings are well-demonstrated by a girl 
who developed poliomyelitis in ado- 
lescence. She was a bright, intelligent 
girl who had previously enjoyed nor- 
mal activities. The poliomyelitis was 
severe, and in the early weeks created 
JANUARY 1967 



.llmost total immobilization. In hos- 
pital, she became depressed and was 
referred for psychiatric assistance. It 
soon became obvious that she was 
concerned about her future, feeling 
that she could never support herself, 
would never marry, and would never 

w
W
.
I
r
am
t
 
future had been destroyed by the 
poliomyelitis. 
It is obvious that the problems will 
be intensified if the individual is intel- 
lectually retarded. It is perhaps less 
obvious that they wiII be intensified 
if the individual shows specific patterns 
of behavior calIed "the organic brain 
syndrome." The behavioral patterns 
noted in this syndrome include marked 
distractibility, an inability to control 
behavior, and an inability to work 
consistently toward an organized goal. 
There may also be distortions of audi- 
tory perception that lead to problems 
in understanding and producing speech, 
or distortions of visual perception that 
may lead to problems in reading and 
writing. D 


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, . 
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.... 
., 
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- '-- 


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JANUARY 1967 


THE CANADIAN NURSE 31 



. 
In 


heart 


Recent advances 


surgery 


In its early stages, surgery of the 
heart was limited to the correction of 
simple congenital lesions. Today open 
heart surgery is capable of correcting 
the more complex forms of congenital 
and acquired heart diseases, and this 
is true even in a far advanced stage of 
the illness. 
At the Montreal Heart Institute, 
surgical procedures have been per- 
formed since 1958. As has happened 
elsewhere, there has been a geometric 
progression in the number of cases per- 
formed each year and in the steady 
improvement of the results. In the 
seven-year period from 1958 to 1965, 
815 patients underwent intra-cardiac 
operations using extracorporeal circu- 
lation. During the first 4 years, 315 
such procedures were performed as 
compared to 500 in the last 3 years. 
The early operative mortality was 35 
to 40 percent, and it has decreased 
progressively during the last period to 
less than 10 percent. This occurred in 
spite of surgical corrections of more 
complex lesions on poor risk patients. 
For instance, during the summer of 
1965, three patients considered mori- 
bunds successfully underwent emergen- 
cy surgical com.ction of multi-valvular 
lesions. 


Extracorporeal circulation 
Improvements in the 
echniques of 
cardio-pulmonary by-pass have opened 
a completely new area in cardiovas- 
cular surgery. To work under direct 
32 THE CANADIAN NURSE 


Today, scientific discoveries are integrated with increasing speed to the field of 
practical application. Heart surgery was born in this age of spdce exploration and 
gigantic scientific achievements. It has rapidly reached the stage of a 
well-established science. 


Pierre Grondin, M.D., and Claude Meere, M.D. 


vIsIon inside the cardiac chambers, all 
venous blood returning to the heart 
must be drained off and returned un- 
der pressure in the arterial system. The 
heart-lung apparatus contains three es- 
sential parts: a pumping system to as- 
sure circulation of the blood, an arti- 
ficial lung to oxygenate the blood, and 
a heat exchanger to diminish oxygen 
requirements of the tissues by lowering 
the body temperature. 
In cases where the ascending aorta 
has to be clamped, like in aortic valve 
replacement, an additional system is 
needed to provide each coronary artery 
with oxygenated blood and thus main- 
tain viability of the cardiac muscle. 
To collect the venous blood, a can- 
nula is placed in each vena cava via 
the right atrium. The blood is drained 
into the oxygenator either by gravity or 
by suction. In the oxygenator, oxygen 
is brought in contact with the blood to 
increase its available oxygen content. 
The oxygenated fluid then goes into the 
heat exchanger where cooling or warm- 
ing is performed. (Fìgure 1.) 
To avoid injury of the blood ele- 
ments (red cells, leucocytes, etc.) the 
pumps must be as atraumatic as pos- 
sible. The blood is returned to the 
body via a cannula which is inserted 
either in the ascending aorta, or in a 
femoral or an iliac artery. To keep the 


Drs. Grondin and Meere are members of 
the Department of Experimental Surgery at 
the Montreal Heart Institute. 


operative field bloodless, a cannula is, 
in most instances, inserted for decom- 
pression in the left ventricle through 
the apex. 
Intracardiac operations can be per- 
formed by different incisions using a 
right or a left thoracotomy. For several 
years, however, a median sternotomy 
has been commonly utilized, thus 
avoiding opening of the pleura. By this 
sternal approach, we are able to cor- 
rect a considerable number of cardiac 
lesions since all the heart valves and 
most of the cardiac chambers are thus 
easily accessible. 
To avoid clotting of the blood in the 
extracorporeal circuit, heparin is given 
intravenously before cannulation of 
the heart and blood vessels. We use 
three mg. of heparin per kilogram of 
body weight. When the intracardiac 
operation is finished, the heparin is 
neutralized by administration of an 
equal amount of protamine. 
In the cardiac surgery, air embo- 
lisms must be carefully avoided, be- 
cause the presence of gas bubbles in 
small arteries acts as a clot causing 
occlusion. Air emboli in small but im- 
portant cerebral arteries are often fol- 
lowed by serious neurological deficits. 
Air embolism is prevented first by 
adding filters to the heart-lung appa- 
ratus and also by careful evacuation of 
air from the heart chambers before 
returning to normal cardiac function. 
Hypothermia is a valuable aid in 
extracorporeal circulation. Today, 
JANUARY 1967 



Fig. 1 


EXTRACORPOREAL CIRCULATION 


OXYGENATOR 


I 
j 
,.1 


DISC 


BUBBLE 


SCREENS 


MEMBRANE 


only moderate hypothermia is com- 
monly used. It consists of a gradual de- 
crease of the central body temperature 
from 37 degrees to 29 or 30 degrees 
(centigrade). At this level, oxygen re- 
quirements of the tissues are decreased 
by 50 percent. 
Many delicate intracardiac proce- 
dures are best performed on a "quiet" 
or arrested heart. Cardiac contractions 
can be stopped by several means. One 
of them consists of inducing a deep and 
selective cardiac hypothermia. These 
low temperatures produce cardiac ar- 
rest and/or ventricular fibrillation. 
More recently, we have preferred the 
use of a small electrical current which 
induces and maintains ventricular fi- 
brillation. Cardiac arrest induced elec- 
trically or by hypothermia is also use- 
ful at the end of cardio-pulmonary by- 
pass to avoid air embolism. 
Many of the early heart-lung systems 
had a huge priming volume. For in- 
stance, the apparatus used at the Mon
- 
real Heart Institute between 1960 and 
1962 needed some 3500 to 4000 cc. 
The priming fluid consisted at that time 
of whole blood, which imposed a tre- 
mendous task upon the blood bank. 
Today this equipment is simplified and 
its priming volume rarely exceeds 1800 
cc. To further reduce the quantity of 
blood needed for priming, and to 
improve capillary perfusion, we dilute 
the priming volume with 5 percent 
glucose in 0.4 NaCl. The ratio is 2/3 
blood and 1/3 dextrose solution. We 
JANUARY 1967 


THERMAL 
EXCHANGER - 


Pump 


also add electrolytes, mainly KCI, to 
prevent postoperative deficit. 
Acquired heart lesions 
The acquired cardiac lesions now 
amenable to surgery are: 1. constric- 
tive pericarditis; 2. aurioculo-ventricu- 
lar dissociation (A V block); 3. massive 
pulmonary embolism; 4. mechanical 
complications of myocardial infarction; 
5. coronary artery insufficiency (angina 
pectoris); 6. traumatic lesions; 7. val- 
vular heart disease. 


Constrictive pericarditis 
Pericardial constriction was not un- 
usual several years ago. It was pro- 
duced in most instances by a tuber- 
culous infection. Now, this disease has 
almost disappeared. At the Montreal 
Heart Institute, only three such cases 
have been admitted for surgery since 
1963. The surgical correction consists 
of the removal of the thickened and 
often calcified pericardium, which acts 
as a shell preventing normal cardiac 
contractions. This disease, affecting 
cardiac filling, is frequently mistaken 
for cirrhosis of the liver. Recovery fol- 
lowing surgery requires a three to six 
month convalescence, but it is quite 
spectacular in most cases. 


Auriculo-ventricular 
dissociation 
Auriculo-ventricular dissociation - 
also called Stokes-Adams syndrome - 
was nearly always fatal within two 


years of onset before artificial pace- 
makers came into clinical use. In this 
ailment, atrial contractions are not 
transmitted to the ventricles because 
of some organic interference with the 
Bundle of His. The rate of ventricular 
contraction is often less than 40 beats 
per minute and sometimes it reaches 
as low as 25 or even 20 beats per 
minute. Episodes of ventricular ta- 
chycardia or prolonged asystole ensue 
and cause inadequate cerebral perfu- 
sion resulting in dizziness and/or syn- 
cope. During these periods of asystole, 
ventricular fibrillation is not uncom- 
mon and is followed by sudden death 
in most instances. 
A V block is mostly a disease of 
people in their sixth, seventh, or eighth 
decade. It results from a degenerative 
process affecting the intracardiac ner- 
vous tissue. However, A V block may 
follow a large myocardial infarct and 
cause a rapid exitus. Treatment of this 
condition with drugs such as isoprote- 
renol is deceiving. The only sure way 
to prevent disaster is to stimulate the 
heart with electricity by an apparatus 
which may be implanted or used ex- 
ternally. To avoid Stokes-Adams ac- 
cidents, electrodes are implanted into 
the heart using an transvenous catheter 
or by a direct transthoracic puncture. 
Once the patient is protected by ex- 
ternal stimulation, an elective opera- 
tion can be performed later which con- 
sists of the implantation of a small 
transitorized apparatus called a pace- 
THE CANADIAN NURSE 33 



maker. (Figure 2.) 
Several types of pacemakers are in 
clinical use. We now prefer a synchro- 
nized apparatus (Atricor made by Cor- 
dis Corporation) which seems to offer 
many advantages over the earlier fixed- 
rate models. The synchronous or P- 
wave pacemaker provides a better car- 
diac output because it regulates the 
ventricular contractions to the atrial 
systoles. It thus permits variations in 
the cardiac rhythm and output ac- 
cording to the needs of the body. 
The surgical procedure of pace- 
maker implantation is simple and its 
mortality is very low. Patients as old 
as 89 years of age were operated on 
successfully at the Montreal Heart In- 
stitute and no operative mortality has 
been deplored. 


Massive pulmonary embolism 
In recent years, the heart-lung ma- 
chine has been simplified rendering 
possible its preparation for cardia-pul- 
monary by-pass in a matter of minutes. 
The cardiac surgeon is capable of re- 
moving massive pulmonary emboli as 
an emergency procedure and saves 
many lives that formerly were lost. The 
treatment consists of extracting the 
clots from the main pulmonary artery 
and its branches. In most cases the 
procedure is complemented by liga- 
tion of a plication of the inferior vena 
cava to prevent recurrent 
mbolization. 
At the Heart Institute, preparation for 
cardio-pulmonary by-pass can be made 
34 THE CANADIAN NURSE 


Fig. 2 


CARDIAC PACEMAKER 


) \ 
--- - ,. --........ 
 
í 

, \ \// 
/ 
 
 ( . y?Ii3 . . .. . ( ( 4 3 1 ) Cardiac stimulation 

 '- Wires inserted through the diaphragm 

 g (2) Rhythmic influx electronic feeding device 
; r g (1) Continuous steam power batteries 


in 15 minutes for such emergencies. 


Mechanical complications of 
myocardial infarction 
Even though surgery is limited in the 
treatment of myocardial infarction, 
mechanical complications of this dis- 
ease - such as ventricular aneurysms, 
perforations of the septum, and rup- 
tures of papillary muscles - can be 
corrected surgically. After an extensive 
coronary thrombosis, some patients 
develop an abnormal dilatation of the 
left ventricular wall. The dilatation 
causes chronic heart failure, mostly 
because of its paradoxical motion. 
These cases respond poorly to medical 
management because the dilated ventri- 
cular wall has no contractile strength 
and has a paradoxical expansion 
during each systole. Cardiac output is 
thus markedly reduced. We have cor- 
rected four such aneurysms with three 
survivals. The operation is rather sim- 
ple. The dilated wall is excised, and 
the mural thrombus removed. The 
ventricular edges are then resutered. 
Postoperatively, these patients are 
markedly improved and can resume 
useful activities. 
Perforation of the septum following 
cardIac infarction is uncommon. Some 
authors report a 50 percent death rate 
within the first week after perforation 
and a survival rate of only 13 percent 
after two months. The surgical pro- 
cedure consists of closing the perfo- 
rated septum under cardio-pulmonary 


by-pass. Three such procedures have 
been performed at the Montreal Heart 
Institute with gratifying results. 


Coronary artery insufficiency 
Chronic coronory insufficiency is the 
most common acquired heart condition 
of our modern time. Until recently, 
even adequate medical therapy with 
vasodilators or anticoagulants and as- 
sociated cessation of all activities was 
unable to lower the mortality rate. 
For the past 15 years various surgI- 
cal procedures have been advocated, 
primarly by Beck, O'Shaughnessy and 
Vineberg. At present, the implantation 
of the internal mammary artery (called 
Vine berg's procedure) is currently per- 
formed in some 25 Canadian and 
American centers. This experience, al- 
though recent, is quite encouraging. 
Surgical technique consists of im- 
planting a systemic artery (the internal 
mammary, an intercostal or a venous 
graft from the descending thoracic 
aorta, etc.) into a myocardial tunnel. 
For diffuse coronary artery disease, an 
epicardectomy is often added along 
with a free omental graft which is 
wrapped around the heart muscle. 
Postoperative cine-angiographic studies 
have shown beyond any doubt satis- 
factory patency of the implanted artery 
and newly developed collateral bran- 
ches. According to more recent studies, 
after eight months the blood flow into 
the implanted artery is equal to the 
flow in a normal anterior descending 
JANUARY 1967 



Fig. 3 


.. 
""- 


'" 


, 


... 


( 


coronary artery. These surgical pro- 
cedures are promising and will play 
an important role in the treatment of 
chronic coronary insufficiency. 


Traumatic heart disease 
Trauma to the heart is not always 
lethal, fortunately. If one adopts a 
prompt and aggressive attitude, it is 
possible to salvage a good proportion 
of such cases. 
All authors agree that upon admis- 
sion, when a cardiac wound is sus- 
pected, a pericardial puncture must be 
performed. By this maneuver the 
diagnosis is confirmed and cardiac 
compression, if present, is temporarily 
relieved. If cardiac tamponnade recurs, 
the heart should be explored and the 
wound sutured. 


Diseases of the heart valves 
Modem cardiac surgery is now con- 
centrating its energy in the correction 
of valvular lesions. Except in cases of 
pure and non-calcified mitral stenosis 
(..dequately treated by commissuroto- 
my) the correction of valvular disease 
requires the insertion of a prosthetic 
heart valve. A variety of prostheses are 
available, but all have the same hy- 
draulic principle of the ball-valve des- 
cribed by Starr and Edwards in 1960. 
(Figure 3.) 
The pros and cons do not differ 
much from one type to another. In all, 
anticoagulants must be prescribed for 
JANUARY 1967 


the entire life of the patient. These 
artificial valves may become partially 
dislodged, throw emboli, or become in- 
fected. More recently, Gordon Murray, 
Donald Ross, and Barrat Boyes have 
popularized the use of homograft 
valves. The danger of embolization and 
infection seems to be lessened with 
these homografts. 
At the Montreal Heart Institute, 
more than 190 patients have been 
operated on for valvular replacement. 
Of this group, 27 have had simultane- 
ous replacement of two valves, either 
the mitral and aortic in 23 cases, or 
the mitral and tricuspid in 4 cases. 
These patients were operated upon 
at a far advanced stage of the disease 
and long term results are very satis- 
factory. An impressive number of these 
patients have returned to a near 
normal and productive life. 


Conclusion 
In recent years, heart surgery has 
reached more unexplored goals than 
any other surgical discipline. Mter es- 
tablishing satisfactory procedures for 
several acquired lesions such as val- 
vular malfunctions, A V blocks and 
mechanical complications of myocar- 
dial infarction, cardiac surgery is now 
claiming continuing success in the 
revascularization of the myocardium. 
Coronary artery disease affects, in the 
United States alone, more than 25 mil- 
lion people. Most authors agree that 


Commonly used artificial heart valves. 
Left to right: Starr aortic; Starr mitral; 
Magovern aortic; Cutter; and Hufnagel 
valve. 


about 5 million such patients can now 
benefit from revascularization proce- 
dures. These accomplishments illustrate 
the enormous possibilities of surgery 
in cardiovascular ailments. A great 
number of cardiac cripples can now be 
rehabilitated to a useful life. 0 


THE CANADIAN NURSE 35 



Intensive care unit 
cardiovascular surgery 


. 
In 


An intensive care unit for patients 
having cardiovascular surgery is de- 
signed to decrease mortality rate and 
to give patients the benefit of highly 
technical care and close observation. 
Such a unit, with its up-to-date equip- 
ment and well qualified personnel, 
helps to eliminate the unfavorable 
effects of anxiety and fear that may 
predispose to postoperative complica- 
tions. 


Physical organization 
The intensive care unit for cardio- 
vascular surgery is not merely a re- 
covery room. Patients are admitted 
as soon as they come out of the operat- 
ing room and the average stay is five 
days. 
To serve both operating rooms of 
the Montreal Institute of Cardiology, 
13 beds are provided in two six-bed 
units and one isolation room. The iso- 
lation room is used to ensure quietness 
and privacy to a severely ill patient, 
to isolate a patient with an infectious, 
disease, or to permit the assembly of 
all machines and equipment together in 
one area for a seriously ill patient. 
A two-bed room is available for 
patients who have not had surgery, but 
whose condition requires close super- 
vision. This includes persons with acute 
pulmonary edema, babies or infants 
who have had heart catheterization, 
and patients being observed after atrial 
defibrillation. 
Space allotted: Approximately 108 
square feet are allotted to each patient. 
36 THE CANADIAN NURSE 


A description of the intensive care setup at the Montreal Institute of Cardiology. 


Cecile Boisvert 


This provides sufficient space for 
equipment and additional personnel in 
case of emergency. 
Direct observation: No system of 
automation, whether it be heart mon- 
itors or other electronic instruments, 
can replace direct observation. For 
this reason, the central station is 
located so that each patient can be 
watched at all times. 
Waiting room for visitors: Even 
though visits are restricted, a waiting 
room in close proximity to the post- 
operative unit is provided for parents 
and relatives. 
Air conditioning: A system of air 
conditioning is essential, not only for 
the comfort of patients and staff, but 
also to offset the heat produced by 
many electronic instruments. Ade- 
quate humidity is also required to keep 
mucous membranes moist and to 
facilitate expectoration of bronchial 
secretions. 


Equipment 
Oxygen and suction: Each unit has 
two oxygen outlets and two wall 
suction connections. One suction outlet 
is for chest drainage and the other for 
oro-nasal or endotracheal aspiration of 
our patients. 


Miss Boisvert, a graduate of St-Joseph's 
Hospital in Trois-Rivières, Québec, special- 
ized in cardiology at I'Jnstitut Marguerite 
d'Youville in Montreal. She is Head Nurse 
of the Intensive Care Unit at the Montreal 
Institute of Cardiology. 


Electrical: Electrical outlets are 
numerous since many electrical de- 
vices are used in the various types 
of treatment. Five double outlets, 
separately fused, are provided per 
patient and a special outlet is available 
in each unit for taking chest x-rays 
at the patient's bedside. 
Monitoring and alarm systems for 
emerg,encies: The heart monitor is of 
special assistance when observing pa- 
tients who have had cardiovascular 
surgery. Numerous complications and 
even fatal outcomes have been avoided 
through the use of such devices. 
A recently published report of 
research undertaken by a team of 
physicians and nurses at the Presby- 
terian Hospital of Philadelphia states: 
"If the heart rhythm can be constan- 
tly observed through the use of mon- 
itors, and if the equipment necessary 
for resuscitation is kept near the pa- 
tient, potentially fatal arrhythmias may 
be detected and treated instantly. Total 
mortality in patients having a myocar- 
dial infarct, at the acute stage, may 
thus be reduced by almost 50 per- 
cent.". 
The monitoring system at the Mon- 
treal Institute of CardiologV includes 
a central complex of monitors which 
indicate heart rhythm, ECG tracing, 


· Lawrence Meltzer. Rose Pinneo, Roderick 
Kitchell, JI/tcllsil'e Corollary Care - A 
Mal/ual for Nurses, Philadelphia. The Pres- 
byterian Hospital. 1965. 
** Ibid. 


JANUARY 1967 



. 
. 


. 


- t::1. 
- t::l. 
- t::J. 
- t=:]. 


. 


and the curve of the peripheral pulse 
of each patient. This central complex 
is located in the nursing station and 
is connected to the cardioscope at the 
bedside. 
The monitoring system also contains: 
a) An alarm system that warns the 
staff if the patient showns signs of 
ventricular fibrillation, tachycardia or 
bradycardia. 
b) A mechanism that operates auto- 
matically or on demand to provide a 
recording on paper of a particular or 
doubtful ECG tracing which the nurse 
has been able to observe on the oscil- 
loscope. These ECG tapes help the 
physician to assess the patient's condi- 
tion; for the nurse, they are indisputa- 
ble arguments to justify her observa- 
tions. 
c) A "memory tape loop" that 
records and retranscribes on paper the 
ECG of the previous three to five 
minutes. With this device, it is possible 
to determine what happened immedia- 
tely before or after the alarm was set 
into action. 
Needle electrodes: The use of needle 
electrodes for ECG has numerous ad- 
vantages. They can be installed in a 
few seconds - an essential in an 
emergency - and eliminate false 
alarms and interference because of a 
poor skin contact. 
Needle electrodes can be left in 
place five to seven days without caus- 
ing the patient discomfort. The skin 
is cleansed with alcohol before the 
JANUARY 1967 


- t::J. 
- t::J e 
- t::J. 
- t:::]. 


. 


ß 


needle is inserted, to eliminate the pos- 
sibility of infection. 


Emergency equipment 
In an intensive care unit, aU equip- 
ment and drugs must be kept in a 
central location. There can be no com- 
promise with this principle. 
Emergency cart: All equipment used 
for resuscitation is assembled on a 
mobile cart that can be rolled quickly 
from the central station to the patient's 
bedside. This represents savings both 
in time and equipment. This cart con- 
tains: a). a portable DC defibrillator 
with electrodes and conductive jelly; b). 
lung ventilation equipment, including 
"Resuscitube," intermittent positive 
pressure apparatus, and endotracheal 
tubes and laryngoscope; c). external 
heart massage equipment, including a 
wooden board, measuring about 3' x 2', 
to place under the patient's chest, or 
an automatic mechanical compressor; 
d). venous dissection equipment; e). 
tracheotomy and tracheal cannulas; 0. 
instruments necessary for emergency 
thoracotomy; g). drugs, including epi- 
nephrine, norepinephrine, Aramine, 
[suprel, bicarbonate of sodium, calcium 
chloride, and Pronestyl; h). sterile 
gloves, syringes, needles, etc. 
The contents of the emergency cart 
are checked carefully each day and 
each time after they are used. 


Personnel 
The care of patients having heart 
surgery involves team work. Good 


Eight-bed central station using Selector 
Monitor with repeat meters and alarm 
lights. A single channel recorder is in- 
cluded for automatic or manual opera- 
tion. 


results cannot be obtained without 
close cooperation between each mem- 
ber of the team. 
Surgeons assume the responsibi- 
lity for patients in the intensive care 
unit, and the residents in cardiovas- 
cular surgery are entrusted with the 
supervision of patients during the entire 
postoperative period. 
Distribution of nursing staff.' Any 
patient who has had cardiovascular 
surgery requires nursing care of a truly 
high caliber. To meet such an objec- 
tive, a strict minimum of eight hours 
care must be provided for each patient 
in a 24-hour period. The nurse's aide 
contributes by performing certain tasks, 
such as bathing the patient, changing 
his bed linen and helping him to eat. 
Selection: Careful selection of nurs- 
ing personnel is essential. Desirable 
personal attributes include: an ability 
to learn and assimilate new techniques 
quickly; emotional stability, which 
allows a person to face emergency si- 
tuations efficientlv; good health, since 
much physical effort is required in the 
unit; a marked interest in and dedica- 
tion to this type of work. 
Previous experience in a recovery 
room or intensive care unit is a great 
asset. It is not, however, a requisite for 
employment. 
Status: Because of the responsibil- 
ities that the nurses in this unit must 
assume, it is logical that they should 
have a distinctivè status and th1t their 
experience be recognized. 
THE CANADIAN NURSE 37 



INTENSIVE CARE UNIT 
IN HEART SURGERY DEPARTMENT 
CJ CJ CJ CJ 
CJ CJ CJ CJ 
CJ CJ CJ CJ 
CENTRAL MONITORING 
STATION PANEL 
+ 

 
CJ 
py 
PHARMACY 


Salary should be commensurate with 
their position. Rose Pinneo, in 
Intensive Coronary Care - A Manual 
for Nurses, suggests a salary approxi- 
mately 15 percent higher than that 
of the basic staff nurse. * * This has 
become policy at most hospitals. 


Staff orientation 
Orientation extends over a period 
of about three weeks, during which 
time the nurse is called upon to assume 
increasingly greater responsibilities. 
Under the guidance of an experienc- 
ed nurse, the new staff member has 
an opportunity to observe patients. 
This phase of learning is planned in 
advance, not left to chance. New tech- 
niques are taught whenever the occa- 
sion permits. 
The surgeons, cardiologist, and resi- 
dents present lectures and clinics for 
the nurses' benefit. Topics include: 
anatomy and physiology of the cardio- 
vascular system; pathology of the heart; 
surgical operations for heart disease; 
drugs used in heart surgery; treatment 
of various arrhythmias; postoperative 
complications and preventive measures; 
oxygen therapy; psychological prob- 
lems of patients having heart surgery; 
and rehabilitation. 
Each staff member is expected to 
learn, through personal reading. about 
ECG tracings and the various arrhyth- 
mias. 
Certain techniques and procedures 
must be learned. These include: mea- 
surement of venous pressure; ope- 
38 THE CANADIAN NURSE 


ration of the cardioscope and pace- 
maker; use of the thermo-regulator 
mattress; handling of the various res- 
pirators; techniques of resuscitation 
and external heart massage; and defi- 
brillation in ventricular fibrillation. 
At the Montreal Institute of Car- 
diology, the nurse has the right, in cer- 
tain circumstances, to carry out ven- 
tricular defibrillation, that is, to give 
the patient an electric shock of 300- 
500 watts per second. Ventricular fi- 
brillation is an extremely serious 
arrhythmia that may cause death if 
nothing is done within three minutes. 
If the nurse encounters ventricular fi- 
brillation in a patient, she must advise 
the surgeon immediately; if, after 60 
seconds, he has not arrived, she starts 
electrical defibrillation to reestablish 
normal heart rhythm. In such circums- 
tances, the surgeon assumes full res- 
ponsibility for her action. 
To familiarize the staff with proce- 
dures performed in an emergency, a 
particularly critical emergency is simul- 
ated using a dummy or a member of 
the staff as a patient. The nurse must 
act exactly as if she were faced with 
a real case of cardiac arrest or a pa- 
tient who has suddenly developed ven- 
tricular fibrillation. Her actions can 
then be assessed and she can be hel- 
ped to improve her technique and save 
time. 


Care is never routine 
Nursing care in cardiology can never 
become a matter of routine. It is given 


on an individual basis according to 
age, type of disease, seriousness of the 
illness and the patient's attitude toward 
his condition. 
The nurse must also be concerned 
with the patient's rehabilitation. She is 
in" a better position than anyone else to 
help him achieve successful rehabili- 
tation. 
Nursing care in heart surgery is a 
real challenge to any nurse. Although 
the work is exacting and the responsibi- 
lities heavy, the reward, also, is great. 
The nurse is compensated for her ef- 
forts when she sees the patient leave 
hospital improved or cured and when 
she knows that she has given him the 
best of her knowledge and skill in the 
most difficult circumstances. 0 


JANUARY 1967 



Varicose veins are characterized by 
permanent overdistention and changes 
of their waUs. This paper deals with 
varicose veins involving the super- 
ficial venous network of the lower 
limbs, especiaHy those situated along 
the internal and external saphenous 
veins. 


Etiology 
Varicose veins usually appear in the 
young adult and increase with age. 
They occur about four times more 
frequently in females than in males. 
They are observed especially in per- 
sons who must stand at their work for 
long periods without moving. Their 
development is, moreover, enhanced 
by frequent pregnancies. 
There is often a hereditary factor in- 
volved. Some persons seem to have a 
constitutional weakness of the valves of 
the veins and an abnormal propensity 
to distention of the venous walls. In 
a study of 1,500 patients with vari- 
cosities, Raymond Tournay found a 
hereditary factor in 90.6 percent. 
The maternal or the hereditary 
influence from the mother's side is 
found in 55 percent of patients. Thirty- 
three percent of the women with vari- 
cosities developed them during their 
first pregnancy. 


Physiopathology 
NormaHy, venous circulation return- 
ing from the lower limbs results from 
the suction effect of the heart and the 
pulsion effect of the muscular massage 
IANUARY 1967 


Varicose veins of the 
lower limbs 


About 10 percent of all adults over thirty-five years of age have some degree of 
varicose change in their saphenous venous system. 


Philippe Dionne, M.D. 


on the deep veins and, indirectly, on 
the superficial veins. Venous flow thus 
goes from the saphenous veins to the 
deep veins. Both mechanisms work 
against two contrary movements: res- 
piration and hydrostatic pressure. 
One theory of varicosities is that the 
venous backflow pushes the blood from 
the deep veins toward the superficial 
veins by means of communicating 
veins, causing gradual dilatation of the 
superficial veins. It is known, however, 
that these communicating veins contain 
valves that aHow the blood to circulate 
only from the surface toward the deep 
veins. (Figure 1.) Nevertheless, when 
varicose veins have already appeared, 
the valves of the communicating veins 
may be forced, little by little, allowing 
the backflow to by-pass them, thus 
increasing varicose distention. This ex- 
plains the aggravation of varicose veins. 
but not how they started. 
At the present time, Trendelenburg's 
theory is the one generally accepted: 
the appearance of varicose veins is 
related to the incompetence of the 
ostial valve situated at the opening of 
the internal saphenous vein into the 
femoral vein. (Figure 2.) The main 
branch of the internal saphenous sup- 
ports all the pressure of the abdominal- 
thoracic blood column, since there is 
no valve between this point and the 
heart. Thus, the first segment of the in- 


Dr. Dionne is a member of the surgical 
staff at SI. Vincent-de-Paul Hospital. Sher- 
brooke. Quebec. 


temal saphenous dilates, and the 
valve closing it at the lower segment is 
forced. bringing about distention of the 
second segment, and so forth. From 
one point to the next, the weight of the 
blood column exerts pressure right 
down to the lower part of the leg. 
This valvular incompetency theory 
has been proved by clinical and ex- 
perimental evidence. Other factors, 
too, may cause a lack of venous tonus 
which favors distention. 


Types 
There are two main types of vari- 
cose veins: essential or idiopathic, and 
secondary, also called substitute or 
compensating. 
All varicose veins of the lower limbs 
are superficial in nature. Certain 
authors speak of "deep" varicose veins; 
however, the anatomy and physiology 
of venous circulation in the lower limbs 
allow us to state definitely that the 
deep veins are not involved in the 
pathological enlargement. Deep varico- 
sities just do not exist. The term has 
merely been used to describe patients' 
complaints of a feeling of heaviness, 
strain. and cramps in the calves of the 
legs after a long period of standing. 
Such discomfort may be the beginning 
of the complication of internal rupture, 
which will be described later. 
Secondary or "substitute" varicose 
veins are characterized by dilatation 
of the superficial venous system. This 
dilatation acts as a compensation fol- 
lowing deep vein thrombophlebitis. 
THE CANADIAN NURSE 39 



2 


4 


Fig. 1. Diagram showing valves in a 
communicating vein. 1) Femoral vein; 
2) internal saphenous vein; 3) commu- 
nicating vein; 4) normal valve that 
opposes flow from the larger vessel 
back into the superficial vessel. 


40 THE CANADIAN NURSE 


Fig. 2. Because of insufficiency of the 
ostial valve, the first segnænt of the 
internal saphenous dilates with corres- 
ponding pressure on the collateral cir- 
culation. The second valve is then 
forced and the second segmem dilates, 
and so on. 1) Femoral vein; 2) pro- 
funda femoral vein; 3) superficial 


Fig. 4. Top: After elevation of the leg, 
compression is applied to the saphenous 
vein. Middle: Leg is lowered and 
varicosities do not appear. Bottom: 
When compression is stopped the 
varicosities immediately appear. 


\. 
, 


. 


, 


, 


Fig. 3. Varicosities of lower leg. 


femoral vein; 4) first segment of 
internal saphenous vein; 5) ostial 
valve; 6) second valve,. 7) openings of 
collateral saphenous circulation. 


Fig. 5. Left: Subject standing - severe 
varicosities apparent. Middle: Subject 
lying down, leg in air - varicosities 
collapse. Right: Subject standing with 
tourniqu,et obstructing the internal 
saphenous - varicosities remain col- 
lapsed, but are scarcely visible. When 
the restriction is removed, the varico- 
sities will fill up from top of leg toward 
ankle, which indicates valvular insuf- 
ficiency at the junction of the internal 
saphenous. 


JANUARY 1967 



" 


Fig. 6. Varicose ulcer. 


Secondary varicose veins are late 
complications that can be caused by 
deep thrombophlebitis in the same man- 
ner as the post-phlebitic syndrome and 
the post-phlebitic ulcer (stasis ulcer). 
Essential or idiopathic varicose veins 
represent the group of common vari- 
cose veins that develop spontaneously 
in the absence of deep venous obstruc- 
tion. A hereditary factor is involved. 


Anatomic pathology 
At first, the clusters of varices 
remain localized in restricted areas. Af- 
ter progressing for a certain time, 
the varices finally invade the whole 
area of the internal saphenous vein 
and sometimes also the area of the 
external saphenous. 
Macroscopically, the affected veins 
are dilated, tortuous, and fluctuant, 
due to their secondary lengthening. 
Their walls are usually thin and calci- 
fied in places. The dilatations often 
wntain calcifying clots (phleboliths). 
Under a microscope, a thickening of 
the tunica can be seen in the early 
stage of the varix. Later, this is re- 
placed by atrophy with sclerosis. 
Changes occur in other tissues of 
the limb. The sclerous tissue around 
the varices finally reaches the nerves 
and the artcries; the subcutaneous cel- 
lular tissue atrophies and becomes the 
site of an edematous infiltration. The 
skin also undergoes important changes. 
It becomes white and glossy in places, 
dry, scaly, and pigmented in others. 
Eczematoid lesions appear and the skin 
JANUARY 1967 


soon becomes badly ulcerated. 


Clinical picture 
Few functional symptoms are evident 
at first. The patient may complain of 
heaviness and fatigue of the limb, with 
malleolar edema in the evening, in- 
creased by standing. Later, he may 
experience acute pain in the form of 
leg cramps. 
The physical signs consist of veins 
that are dilated in the form of bluish 
cords, and uneven flexuosities, situated 
most frequently along the internal sa- 
phena, Le., along the inner surface of 
the thigh and the leg. Varicose veins 
partly disappear when the patient is 
recumbent in the supine position. They 
can be partially reduced by pressure. 
(Figure 3.) 
The Trendelenburg test helps to de- 
termine the location of incompetent 
valves. With the patient lying down, 
the leg is elevated to empty the super- 
ficial veins. The outlet of the saphena is 
compressed and the patient then is 
asked to stand. If the ostial valve is 
incompetent, the varicose veins fill 
again suddenly from the top to the 
bottom as soon as the digital compres- 
sion is removed. (Figure 4.) 
The Trendelenburg test may also 
be used to demonstrate incompetent 
perforating veins. The limb is raised 
to empty the saphenous; the outlet of 
the saphenous is compressed, and the 
limb then is lowered without stopping 
compression. If the perforating veins 
have competent valves, the vein fills 


slowly; if the perforating veins do not 
have competent valves, filling occurs 
rapidly. (Figure 5.) The multiple-tour- 
niquet test is also helpful in locating 
the position of incompetent perforating 
veins. 
Perthes' test, which consists of com- 
pression of the saphenous trunk in the 
thigh followed by exercise carried out 
by the patient, is useful to evaluate 
the patency of the deep venous system. 
If the deep veins are blocked, the vari- 
cosities become enlarged and the pa- 
tient feels a pain in the calf of the leg. 
Phlebography supplies two types of 
information: it helps the physician to 
evaluate the deep circulation and to 
localize the incompetent perforating 
veins. 


Complications 
Complications represent the serious 
aspects of varicose veins. 
1. Rupture: External rupture occurs 
through a gradual thinning of the 
dermis over a dilated varix. Suddenly, 
without apparent cause or pain, the 
hemorrhage occurs. Although it may 
be serious, it can usually be controlled 
by elevating the limb and applying a 
pressure bandage. 
Internal rupture occurs over the 
deep veins of the calf. The patient ex- 
periences a sharp and sudden "whip- 
lash" pain followed by lameness. In the 
ensuing days a painful induration ap- 
pears over the calf of the leg, oc- 
casionally accompanied by ecchymosis. 
2. Varicose phlebitis: This com- 
THE CANADIAN NURSE 41 



plication, which generally involves the 
superficial varicose veins, is common. 
Clinically, edema and local erythema 
are noted. The venous cord becomes 
hard, knotty and painful. Sometimes 
the phlebitis will extend the entire 
length of the internal saphenous. It 
rarely gives rise to emboli, but is 
stubborn and recurring. More often 
than not, the inflammation subsides, 
leaving an indurated cord; however, 
it may progress to suppuration. 
3. Trophic skin: Patches of pig- 
mented skin and dry or oozing eczema 
are commonly found. 
4. Varicose ulcer: This is the most 
common and most serious complica- 
tion, since it resists treatment and 
recurs easily. (Figure 6.) Its pathogeny 
is complex. Nutrition of the tegument 
of a varicose limb is poor for two 
reasons: venous stasis and nerve 
changes as a result of sclerosis. 
Clinically, the varicose ulcer is observ- 
ed most frequently in the lower half 
of the inner surface of the leg. It 
begins following minimal excoriation 
of the skin, caused by trauma or 
eczema. 
The ulcer gradually enlarges and 
may reach considerable dimensions. 
Its edges are sharp, quite regular, thick 
and adherent. The base of the ulcer is 
irregular, greyish, and atonic, and 
secretes a turbid serous discharge. The 
skin surrounding the ulcer is brownish 
in color. If not treated properly, the 
ulcer gradually increases in size. With 
adequate treatment it may be cured, 
but it recurs with extreme facility. 
The common varicose ulcer must be 
differentiated from the post-phlebitic 
chronic ulcer or "stasis ulcer," which 
represents a separate entity. The latter 
is found in patients who have suffered 
deep phlebitis of the lower limbs some 
years previously and who, afterwards, 
have shown the syndrome known as 
the "post-phlebitic leg": vague pain; a 
feeling of heaviness, fatigue, and 
cramps in the affected limb; and the 
appearance of hard and sometimes 
ligneous edema. At first, the skin has 
a smooth, glossy appearance with 
brownish-red pigmentation. 
Although varicosities may not exist 
prior to or during the course of the 
42 THE CANADIAN NURSE 


phlebitis, they may appear later. After- 
ward, the ulcer sets in and resists 
almost any type of treatment. 
Our present knowledge of the causa- 
tive mechanism of "stasis ulcer" now 
enables us to treat it successfully with 
surgery. Deep thrombophlebitis, in its 
acute phase, completely blocks the 
deep vein of the limb. With time and 
treatment, the acute phase subsides. 
Later, the vein becomes more or less 
permeable again, but like a rigid tube, 
having lost its elasticity. Muscular mas- 
sage is no longer effective; hence, there 
is a backflow through the communicat- 
ing veins and a consecutive stasis in the 
superficial venous network with the 
onset of substitute varicose veins and 
a stasis ulcer. 


Treatment 
Uncomplicated essential varicose 
veins are relatively easy to manage. 
Small varices that give little trouble can 
be treated by having the patient wear 
elastic stockings; the compression thus 
achieved is sufficient to prevent the 
evolution of lesions. If, however, the 
patient refuses to wear elastic stockings 
permanently, sclerosing solutions can 
be injected particularly in the case of 
moderate and well-localized varicose 
veins. The injection of sclerosing solu- 
tions has a positive effect; this treat- 
ment involves little risk, allows the 
patient to be ambulatory, and has the 
advantage of curing the disorder with- 
out leaving scars. The injected scleros- 
ing solution induces a localized obli- 
terating endophlebitis which transforms 
the varix into a solid cord. 
The purpose of the sclerosing treat- 
ment is to prevent lesions and later 
complications from developing. It will 
give excellent results if it is started 
early and if the patient regularly visits 
his physician to have him sclerose any 
ulterior varicose dilatation. It will be 
more effective if the patient is well 
aware of his or her condition and 
understands the importance of wearing 
elastic stockings. 
If, however, the patient refuses to 
wear such stockings; if he or she does 
not want to undergo the continuous 
sclerosing treatment; if the varicose 
veins are enormous; or if the patient 


shows one of the serious complications 
of varices, surgery is the only effective 
treatment. The latter consists of the 
division of the great saphenous vein 
at the saphenofemoral junction, with 
ligation of all its collaterals, and the 
stripping of the entire internal saphe- 
nous vein from the groin to the internal 
malleolus. lf indicated, the perforating 
veins, especially those in the upper 
third of the leg, are ligated as well. 
Sclerosing solutions may be injected, 
if necessary, pre- or postoperatively to 
avoid too many scars. After surgery, a 
compression bandage is applied to the 
limb to prevent hemorrhage. 
Walking is resumed the following 
day to avoid stasis and deep thrombo- 
ses. The functional and esthetic re- 
sults of such operations are excellent. 
The destruction or eradication of 
the varicose veins by surgery automa- 
tically cures a varicose ulcer. If, 
however, the ulcer is of a large di- 
ameter, over 2 cm., for instance, its 
recurrence will be prevented by ex- 
cising the ulcerated area and applying 
a dermo-epidermal graft. 
The recurring post-phlebitic ulcer 
(stasis ulcer) is treated surgically ac- 
cording to a special technique, after 
the surgeon has made certain that the 
deep circulation is adequate. The ulcer 
is widely excised to the level of the 
fascia; then, the underlying perforating 
veins are ligated even beyond the 
fascia to block the backflow to the 
surface. Frequently, the detachment of 
a large flap that includes the fascia 
helps the surgeon to ligate the perforat- 
ing veins beyond the ulcerated areas. 
Finally, a dermo-epidermal graft com- 
pletes the procedure. 
Secondary varicose veins that ac- 
company the ulcer are treated as essen- 
tial varicose veins. Faced with a 
varicose ulcer and varices complicated 
by obstruction of the deep circulation, 
the surgeon has the worst problem to 
solve. The stripping of part of the 
varicose veins may improve the limb. 
In addition, instructions to the patient 
about the importance of decreasing 
stasis and avoiding trauma, even the 
slightest one, may help him to avoid 
complications and minimize his dis- 
ability. 0 
JANUARY 1967 



The patient who is to have ligation 
and stripping of varicose veins is 
usually admitted one or two days prior 
to surgery. Preoperative nursing care 
is started immediately. 


Preoperative care 
The patient is allowed out of bed 
only to go to the washroom. She wears 
elastic bandages on her legs at all times 
to prevent blood stasis in the veins. 
The nurse explains and demonstrates 
the correct procedure for applying the 
bandages. 
Two four-inch-wide bandages are 
used for each leg and are applied by 
the patient before rising in the morn- 
ing. Prior to this she elevates both 
legs for about four minutes to drain 
blood from the veins by gravity. 
To be useful, the bandages must be 
applied correctly. Wrapping should 
start close to the toes, with three turns 
around the foot and three figure-8 
turns around the ankle. The second 
bandage is then continued up the leg, 
using spiral-reverse turns to provide 
better support and to avoid uncomfort- 
able folds. The compression of the 
bandage must be strong over the feet 
but less at the ankles and the calves, 
to avoid edema of the feet and toes. 
The foot of the bed should be raised 
by two or three notches (about eight 
inches). 
Physical preparation also includes 
teaching the patient the various respir- 
atory and spirometric exercises that 
she will be required to carry out post- 
operatively. 
JANUARY 1967 


Nursing care in 
. . 
varicose vein surgery 


Teaching the patient ways to help prevent the recurrence of 
varicosities is an important aspect of care. 


Murielle Rodrigue 


Psychological preparation is as im- 
portant as physical. All procedures are 
explained to the patient, and she is 
given an opportunity to express her 
fear of pain and discomfort. In certain 
cases, apprehension may be due to 
fear of the recurrence of the varico- 
sities after surgery. The nurse explains 
that the operation is a successful form 
of treatment, and that active treatment 
at this stage will avoid later complica- 
tions such as phlebitis, ruptures, vari- 
cose dermatitis and ulcers. 
On the evening before surgery the 
pubis and both legs are shaved. Shav- 
ing is done carefully, since the skin 
over the varicose veins is very thin and 
fragile. Cuts and scratches could lead 
to infection and thus to postponement 
of the surgery. The risk of infection is 
reduced by applying Betadine soap, 
which contains 0.75 percent of free 
iodine, to the legs. 
The nurse takes this opportunity to 
explain to the patient the dangers of 
using a depilatory cream, especially if 
there is an ulcer. These substances are 
much too irritating for delicate skin 
and may cause a dermatitis to develop. 


Postoperative care 
A cradle is placed on the patient's 
bed to prevent the weight of the bed- 
clothes from resting directly on her 
legs. The foot of the bed remains rais- 


Miss Rodrigue is Supervisor and Clinical 
Instructor of Surgical Nursing at the St. 
Vincent de Paul General Hospital School 
of Nursing in Sherbrooke. Quebec. 


ed by 8 inches to aid venous return. 
In addition to routine supervision, 
the nurse closely observes the incisions 
in the region of the groin, knee or 
instep for possible hemorrhage or 
hematomas. If there is bleeding, she 
applies manual pressure over the area 
and notifies the doctor. She also notes 
the color of the skin and any edema of 
the toes. 
Except by order of the physician, 
bandages around the legs are not re- 
moved. Only the surgeon or his assis- 
tant changes the dressings. 
The patient is encouraged to move 
her toes, ankles, and legs as soon as 
possible after the operation, even if 
this is painful. The nurse remains with 
her as she attempts these exercises for 
the first time, to give her moral sup- 
port. She explains that the stitches will 
not give and that the sooner and more 
frequently the patient makes these 
movements, the sooner the pain will 
disappear. Generally the patient is al- 
lowed to walk the day after surgery. 


Early ambulation 
The patient may complain of a tug- 
ging pain over the groin, caused by 
the dressing and the stitches, when she 
first walks. She is warned not to touch 
the dressings, as there is a risk of 
contaminating the wound. If edema ap- 
pears in the limb during ambulation, 
the patient is put back to bed with 
her legs raised on pillows. 
The patient should walk about and 
not remain standing. It is preferable 
for her to get up several times a day 
THE CANADIAN NURSE 43 



for short periods each time. When she 
is sitting, she should prop her legs on 
a stool. 


t 


Convalescence 
The nurse gives the patient general 
instructions about future care to 
prevent the recurrence of varicosities. 
She advises the patient to continue to 
wear the elastic bandages until the 
doctor suggests that she wear elastic 
stockings. Both stockings and bandages 
should be put on in the morning and 
left on until bedtime. 
The patient is told that she can 
prevent dryness of the skin and scaling 
by applying vaseline or a lanoline-base 
oil; any other medicated ointment 
should be avoided. In addition, she 
should not scratch her legs, because of 
the danger of producing a varicose der- 
matitis. 
The nurse explains why the patient 
should avoid wearing stocking sus- 
penders or panty girdles which com- 
press the veins in the area of the groin 
and the thigh. She warns the patient 
against crossing her legs when sitting, 
and standing for prolonged periods. 
She suggests that the patient should 
raise the foot of her bed at night, and, 
two or three times during the day, 
allow about 20 to 30 minutes of rest 
with legs elevated. 
The patient is told to avoid any 
trauma that might bruise, scratch or 
cut her legs. If her limb is injured in 
any way, she should inform her phy- 
sician. 
Patients suffering from varicose 
veins should consult their physician 
regularly two or three times a year, 
especially if they have undergone 
surgery. This enables the surgeon to 
give better follow-up care to his patient 
and to find out if she has really 
followed his instructions. 0 


, \ 


- 


} 


\ 


.... 


... 


.. 


The nurse explains and demonstrates 
the correct procedure for applying 
elastic bandages to the legs. 
JANUARY 1967 


44 THE CANADIAN NURSE 



Effectiveness of nursing visits 
to primigravida mothers 


The purpose of this project was to 
study the effects of public health 
nursing visits on the concerns of the 
young primigravida mother with her 
first baby. Two groups of mothers 
were used: one group had public health 
nursing visits, and the second group 
had no visits by a public health nurse. 
The concerns of the mothers in the 
study were assessed at two time in- 
tervals: once during the mother's stay 
in hospital, and again after she had 
been at home with her infant for four 
weeks. 


Need for the study 
The increasing demands for service 
from the other program areas of pub- 
lic health nursing have focused atten- 
tion on the traditional maternal and 
child health services of the public 
health agencies. Public health nurses 
are faced with the dilemma of con- 
tinuing with an established educational 
program or of abandoning it in favor 
of the pressing needs to provide new 
home care programs or rehabilitative 
services. 
Two arguments are most frequently 
used for either changing or maintain- 


Miss Brown, a 1965 CNF Scholar, is a 
lecturer at the University of Western Ontario 
School of Nursing, London, Ontario. She 
based this article on a project completed 
in 1965 as partial requirement for her 
M.S.N. degree at Western Reserve Univer- 
sity, Cleveland, Ohio. The complete thesis 
has been deposited in the CNA library. 
JANUARY 1967 


On testing the hypotheses that primigravida mothers who had public health 
nursing visits during and at the end of their first four weeks at home would have 
fewer, and less intense, concerns about infant care than mothers who did not 
receive visits, the author reached some surprising conclusions. 


Louise S. Brown, B.Sc.N., M.S.N. 


ing the nursing service. One IS that 
the mother of today receives all the 
help she needs from her family physi- 
cian and from the body of knowledge 
she has acquired through her reading 
and general education. The public 
health nurse, therefore, would spend 
her time more profitably by limiting 
her visits to those families who either 
have requested her visits or who have 
obvious health needs. This means 
that routine visits to all postpartum 
mothers should be eliminated and 
only visits on a priority basis be under- 
taken by the public health nurse. 
The other point of view is that the 
maternal and child health program is 
the basis of a public health nursing 
service, and through it many beginning 
health problems are discovered. It is 
in this early mother-child relationship 
that the foundations are laid for the 
child's future development and health.! 
The public health nurse is most help- 
ful by providing assistance to the 
mother in understanding her child's 
growth and development and her new 
role as a mother. To do this effective- 
ly, she needs to visit the homes of all 
new parents to assess how she can 
help these expanding families. While 
assisting the young parent, the public 
health nurse also achieves two of the 
basis tenets of a public health service: 
the promotion of health, and the pre- 
vention of disease. 
The Expert Committee of the World 
Health Organization states that a pro- 
gram of health services will be effective 


if it is built on the needs of the people 
served.:! The public health nursing 
programs must meet the same cri- 
terion. Research is needed to determine 
the needs of the mother and the effect 
of public health nursing visits on these 
needs. Until this kind of information 
is available, there is no scientific evi- 
dence to support either of the two 
previously stated points of view, that 
is, to limit or to expand the public 
health nursing program in maternal 
and child health. 
The investigator developed the fol- 
lowing research design to discover the 
concerns of the new mother and the 
effect of public health nursing visits 
on her concerns. 


Review of the literature 
No literature is available on the ef- 
fectiveness of public health nursing vis- 
its to the primigravida mother. There 
are, in fact, only a few studies 3 . 4. 5. 6. 7 
that discuss the public health nursing 
programs in the area of the mother 
and her infant. * These studies have 
assessed the existing services in ma- 
ternal and child health at prenatal 
classes child health centers, and in 
home visits. Of the studies, only those 


* Since this study was completed, another 
study by Dr. H. Carpenter has been publish- 
ed: The Need for Assistance of Mothers 
with Their First Babies During the Three- 
Month Period Following the Baby's Birth. 
Toronto, Univ. of Toronto, School of Nurs- 
ing. Alumni Assoc., 1965. 
THE CANADIAN NURSE 45 



done by Hunter and Carpenter
' a 
focus upon the help the public health 
nurse provides in her home visits to 
the mother with her newborn infant. 
A study done by Adams, R while not 
discusing the role of the public health 
nurse, explores in detail the "early 
concerns" of the primigravida mother 
about the care of her infant during 
the first four weeks at home. 
Hunter's study analyzes the routine 
visits made by public health nurses in 
a large city to all newborn infants. 
The method of study is to ask the 
public health nurse to complete a 
questionnaire following each of 10 
visits to a mother and her newborn 
infant. The result is an interpreta- 
tion of the value of the service by 
the participating public health nurses. 
Eighty-one percent of the nursing visits 
are judged to be valuable. The study 
concludes that the service is meeting 
a need but that the need has changed. 
The physical needs of the infant have 
become less of a problem to the mother 
since, in most cases, the mother is 
able to handle this herself. The new 
needs are reported to be: the mother's 
feeling toward her baby, her own 
problems, and problems in family 
dynamics. 4 
I Carpenter's study is an analysis of 
home visits by the public health nurse 
to mothers of newborn infants resid- 
ing within the area of a health unit. 
The home visits are analyzed through 
the use of tape recorders and ob- 
servers. It is found that of the 38 
mothers of first children, 20 asked 
the nurses about the normal growth 
and development of their children. 3 
What these questions are, and how 
the public health nurse assisted the 
mothers in finding the answers is not 
reported. ** Because of the anxiety 
expressed to the nurses and the reports 
made by the observers, Carpenter re- 
commends in her study that the mother 
with her first baby should be given 
priority upon public health nursing 
time. She recommends, also, that to 
be most useful, this service should be 
available as soon as possible after the 
mother's return home from hospital. 3 
The third study by Adams is an 
exploratory one to determine: 1. the 
concerns of the primigravida mother 
in caring for her infant; 2. how these 
change over a period of time; and, 
3. whether or not they are related to 
the infant's birthweight. The samples 
used are 20 primigravida mothers of 


** Carpenter's second study of the need 
for assistance of mothers with first babies 
identifies many concerns about infant care. 
Most of these concerns are used by this 
investigator in developing the tool for as- 
sessing the effects of public health nursing. 
46 THE CANADIAN NURSE 


infants of normal birthweight and 20 
primigravida mothers of infants of 
premature birth weight. The 40 mothers 
are interviewed at three time periods 
throughout the first month of infant 
care, once in the hospital and twice 
at home. Five areas of worries are 
described: feeding, bathing, crying, 
care of the navel, and/or circumcision, 
and other. Feeding is the major con- 
cern for all mothers throughout the 
month. "Other concerns" rank second, 
and crying is third. Birthweight does 
not influence the results of the study. 
 
rt is further stated that the early 
days of care in the hospital and at 
home may be times of "special needs" 
for new mothers. Mothers of infants 
of premature weight in the study rely 
on nurses in helping to care for their 
newborn infants. Mothers of children 
of normal birthweight use their family 
and friends to help them. It is not 
reported whether or not public health 
nursing visits were made to all the 
mothers in the study. A recommenda- 
tion made in this study is that a nurse 
working closely with the physician 
could answer the mother's questions 
and convey information to him about 
the mother's progress in caring for 
her infant. 8 
In summary, the studies by Hunter 
and Carpenter approach the public 
health nursing services through the 
public health nurse. No attempt is 
made to ascertain from the mother 
what her concerns are in regard to 
infant care.t The study by Adams, 
on the other hand, concentrates on the 
mother's concerns, but there is no evi- 
dence that the effect of the public 
health nurse is considered. 
Because of the lack of literature 
about the effect of public health nurs- 
ing visits on the fears of mothers in 
caring for their infants, the following 
research proiect was developed to 
examine it. The design combines the 
studies done by the aforementioned 
investigators, the effects of the public 
health nursing service, and the con- 
cerns of the mother about infant care. 
The primigravida mother is begin- 
nine; her experience as a mother and 
will not have learned to adjust to the 
problems of child care, while the 
mother with other children has learned 
how to care for infants and has an 
established pattern of child-rearing 
methods. The primigravida mother has 
many problems associated with infant 
care as demonstrated by Adams' study. 
She seems to want help as indicated 
bv Hunter and Carpenter. The mother 
with her first-born child was selected 


t In the second study by Carpenter, infor- 
mation is obtained from the mothers to as- 
certain their needs. 


for this project because of the above 
observations. The study by Adams 
was of considerable value in defining 
terms and in the construction of the 
instrument used in this study. 


Hypotheses tested 
For the purpose of this study, the 
following hypotheses were tested: 
I. Primigravida mothers who have 
public health nursing visits will have 
significantly fewer concerns about the 
care of their infants than mothers 
who do not have public health nurs- 
ing visits during the first four weeks 
they are at home with their infants. 
2. Primigravida mothers who have 
public health nursing visits will have 
a significantly greater reduction in the 
intensity of the concerns that still re- 
main at the end of the four weeks at 
home than those mothers who do not 
have public health nursing visits. 


Terminology 
Primigravida mother as us
d in this 
study is a woman who has given birth 
to her first child and who has never 
lost a previous pregnancy. 
A concern is any aspect of infant 
care that worries a new mother. 
Intensity of concern is the degree 
of the concern as judged by the mother 
on a scale ranging from no concern to 
extremely concerned. 
Newborn infant is any infant born 
to the mothers in the sample who are 
of normal birthweight and are without 
any physical defects. 
Public health nursing visits are visits 
made by a nurse employed by a volun- 
tary or an official health agency to 
the primigravida mother in her home. 


Methodology 
The mothers in this study were 
drawn from the regular admissions to 
the maternity wards of primigravida 
mothers after their delivery. Their se- 
lections was made according to the fol- 
lowing criteria: 
1. The mother is 20 to 29 years 
of age inclusive. 
2. The pregnancy is without recog- 
nized complications. 
3. The mother does not have an as- 
sociated illness and is well and able 
to care for her infant. 
4. The mother has delivered a normal 
infant of normal birthweight and with 
no physical defects. 
5. The mother and her child are 
under the care and supervision of a 
family physician. 
6. The mother is married and living 
with her husband. 
7. The husband is currently employed 
or has a means of income not con- 
sidered to be welfare. 
Two hospitals were used in the 
JANUARY 1967 



, 


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, 
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IANUARY 1967 


- 
...... 



 
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, 


... 


;. 


., ... 


, . 


.... 


.. 


study and the first 20 mothers who 
met the criteria from each hospital 
were designated as Group A and 
Group B respectively. Group A moth- 
ers had visits from a public health 
nurse and Group B mothers did not 
have public health nursing visits. 
The sample mothers were contacted 
twice: on the third or fouth day post- 
partum in hospital, and after they had 
been at home caring for their infants 
for four weeks. At both of these times 
the mother was asked to complete the 
same questionnaire about infant care. 
In hospital the mothers were contacted 
personally by the investigator. The 
second contact was made by mail. 
The instrument used in the study 
was a questionnaire developed by the 
investigator from her personal exper- 
iences as a public health nurse and 
from writings on child care, especially 
the article by Adams. 8 It attempted 
to assess the level and intensity of the 
mother's concerns about infant care in 
the following broad areas: bathing, 
crying, feeding, elimination, routine 
care, and sleeping. Three of these 
areas, feeding, crying, and bathing, 
were found by Adams to be problems 
for the mothers. 
The mothers were also asked to 
rank the six areas of infant care in 
order of their importance to them and, 
after four weeks, to indicate the three 
most helpful persons to them during 
the past four weeks, and the number 
of physician contacts they had made. 
Identifying data about the mothers 
were taken as well as some indication 
of their knowledge and experience in 
child care. 
The chi-square test was used to 
support or reject hypothesis one. The 
test for hypothesis two was the Mann- 
Whitney V-test. Any differences oc- 
curring beyond the 5' percent level of 
chance were considered significant in 
applying these tests. 


The findings 
Forty primigravida mothers were in 
the sample and all 40 mothers return- 
ed the first questionnaire. All but one 
returned the second questionnaire. 
This mother was in the group with 
public health nursing visits. 
The tests revealed that for this study 
the two groups of mothers could be 
considered to be from the same popu- 
lation except for the level of educa- 
tion and the number of mothers who 
worked following their marriages. The 
non-service group of mothers had a 
higher educational level, worked less 
frequently following their marriages, 
and tended to have more help at home 
with their infants. The control group 
of mothers lived in a geographically 
different community from the mothers 
THE CANADIAN NURSE 47 



with public health nursing service. No 
attempt was made to assess the socio- 
economic levels of the parents. The 
mothers in Group B probably had 
an advantage here as well, since educa- 
tion is one indicator of this status. 


Hypothesis One 
In general, sample A mothers in- 
dicated more concerns at time one in 
all areas of infant care except crying. 
This group had more "not stated" re- 
sponses than Group B. At time two, 
the same trends continued with one 
exception. The test mothers also re- 
ported fewer concerns than the control 
group about feeding their infants. 
Bathing: Both groups showed a re- 
duced number of concerns about bath- 
ing their infants from time one to time 
two. Although these results were great- 
er for the mothers with nursing care, 
the difference was not significant and 
hypothesis one was not supported. 
Crying: The number of concerns 
about the crying of the infants was 
significantly reduced for each group 
after four weeks. The results, how- 
ever, did not indicate a significant 
enough difference between the two 
groups to support hypothesis one for 
crying. 
Feeding: At time one, the mothers 
in sample A had significantly more 
concerns about the feeding of their 
infants. At time two, there was a sig- 
nificant reduction in the conceFns of 
the primigravidas with nursing care, 
while the mothers without this help 
did not achieve this. Hypothesis one 
was supported for feeding. 
Elimination: No real difference was 
indicated for either group of mothers 
after four weeks of caring for their 
children. Hypothesis one was not sup- 
ported for the primigravida mother's 
concern about her infant's elimination. 
Routine care: Although each group 
of mothers was able to reduce her 
concerns about the routines of infant 
care significantly from the time in 
hospital, the difference between the 
groups after four weeks was not ade- 
quate to support the hypothesis. 
Sleeping: The control mothers show- 
ed significantly fewer concerns about 
the sleeping habits of their infants 
than the mothers with nursing care 
at both times. The change in the num- 
ber of concerns from time one to time 
two, however, was not significant 
enough between the groups to support 
the hypothesis. 


Hypothesis Two 
In general, at time one in hospital, 
the scores of the intensity of the con- 
cerns about all areas of infant care 
were higher for those primigravidas 
who had public health nursing visits. 
48 THE CANADIAN NURSE 


At time two, the total scores for each 
concern was reduced except for sam- 
ple B in the area of sleeping. This 
score was elevated at time two. 
Bathing: Both groups of mothers 
showed a reduction in the intensity of 
their concerns in this area to well 
below the level of chance over the 
four-week period. The difference be- 
tween the groups, however, was not 
sufficient to support hypothesis two 
for bathing. 
Crying: After four weeks at home, 
the mothers in sample A had not 
shown a significant reduction in the 
intensity of their concerns over their 
infants' crying. This, however, did not 
hold for the mothers without nursing 
care. The results obtained were very 
significant and in the opposite direc- 
tion to that proposed by the researcher. 
Feeding: The in-hospital data col- 
lected from the mothers were signifi- 
cant for the mothers in the test group. 
These mothers had a much higher 
intensity score about the feeding of 
their infants. After four weeks they 
were able to reduce this score to a 
level of probability of less than .005. 
Group B, on the other hand, had no 
significant change in either direction. 
Hypothesis number two was accepted. 
Elimination, routine care, and sleep- 
ing: The null hypothesis was accepted 
for these three areas. No statistically 
significant data were obtained and 
hypothesis two was -not supported. 
Public health nursing visits made no 
appreciable difference in the intensity 
of the mothers' concerns about the 
elimination, routine care, or the sleep- 
ing of their infants. 
For both groups of mothers at the 
two times, crying ranked first and 
feeding second. There was some shift- 
ing of the other four areas at the two 
times tested, and the differences ob- 
tained are questionable as to prefer- 
ence over another concern. 
A difference also appears in com- 
paring the ranks of the mothers in this 
study with areas of concern as found 
by Adams. 8 The sample as a whole 
placed crying first and feeding second. 
In Adams' study, the reverse was 
found. Primigravida mothers with and 
without nursing service listed their 
husbands first and their mothers sec- 
ond in terms of helpfulness to them 
over the four-week period. The third 
most helpful person for group A moth- 
ers was the public health nurse. She 
was ranked first by three of eight pri- 
migravidas in the sample. 
In all cases, it was the mother who 
was visited by the nurse from the 
voluntary agency who indicated the 
nurse as helpful. In one unsolicited 
response, however, a mother who was 
visited by a nurse from the official 


agency wrote in the following state- 
ment at the end of a lengthy note 
about her infant's crying: "I found that 
if for nothing else it helps to talk with 
the public health nurse because it reas- 
sures you and you can ask about small 
worries without having to disturb your 
doctor." 
In third place for Group B mothers 
was a variety of other family mem- 
bers. The physician was placed fifth 
by both groups. 
The number of physician contacts 
also varied for each group. The moth- 
ers with nursing visits had an average 
of 2.5 physician visits, while the 
mothers without nursing had an aver- 
age of 2.0 visits. 
Two mothers from sample A and 
three mothers from sample B had no 
contact with their physicians during 
the period of the study. The maximum 
number was five contacts made by 
two primigravida mothers in Group A. 
One mother in Group B had as many 
as 10 contacts with her physician dur- 
ing the study period. 


Discussion and conclusion 
The long term purpose of this study 
was to find objective evidence to use 
in the following controversy in public 
health nursing programs: the contin- 
uance of a maternal and child health 
program as opposed to the curtailment 
of this service in favor of newer pro- 
grams in other areas. The literature 
available to the investigator was limit- 
ed and none of the reports attempted 
to compare two groups of primigravida 
mothers - one with nursing care and 
one without - to clarify the effects 
of public health nursing services. The 
results of the present study do not 
strongly support either of the two 
arguments. In spite of limitations in 
its sampling, the data do point out 
pertinent directions for further study 
of the controversy. 
The major findings of this study 
were: The public health nurses had a 
positive effect upon both the number 
and intensity of the primigravida moth- 
er's concerns about the feeding of her 
infant. A second major finding was in 
the opposite direction than predicted 
by the investigator. Although no differ- 
ence was found with the group of moth- 
ers who had public health nursing care 
for numbers of concerns about crying, 
the primigravida mothers who did not 
have visiting nurses had a greater re- 
duction in the intensity of their con- 
cerns about their infant's crying. 
In comparing the changes that oc- 
curred within each group over the 
four weeks for the total sample, there 
was no reduction made in either the 
number or the intensity of concerns 
about the infant's sleeping. Bathing 
JANUARY 1967 



concerns were reduced both in num- 
ber and intensity for all primigravidas. 
No reduction in the intensity of the 
concerns for elimination and feeding 
was evident, although the numbers of 
these concerns were reduced for all 
primigravidas over the four weeks. 
The findings relating to feeding and 
crying suggest that the effects of pub- 
lic health nursing visits require further 
study. Why do mothers without nurs- 
ing care have reduced intensity of con- 
cerns about crying? Why does the pub- 
lic health nurse produce improvement 
in the mother's concerns only in the 
area of feeding? Answers may be with 
the quality of an instrument to assess 
these areas accurately and it may also 
be in the quality of the nursing service 
given. Such questions could be answer- 
ed by further study using three groups 
of mothers: one without public health 
nursing, one with the usual public 
health nursing, and a third group of 
mothers given excellence in nursing 
care by a select group of nurses with 
controlled supervision. 
Another factor that influences the 
number and intensity of concerns lies 
with the mothers and cannot be con- 
trolled. The mother, in hospital before 
she has had any experience with her 
own infant, seems unable to assess ac- 
curately what areas will be of concern 
to her and how much of a concern. 
Some areas that are not problems in 
hospital become major problems as 
the child grows. Other concerns disap- 
pear completely as the new mother 
benefits from her experience. All the 
mothers in the sample ranked crying 
as number one and feeding as number 
two while in hospital, and later after 
four weeks. Adams also found crying 
of major importance but it was second 
to feeding. s In that study, however, 
no public health nursing services were 
available and half of the mothers gave 
birth to premature children. 
The results in the present study are 
ambiguous. Feeding was positively im- 
proved for the mothers with nursing 
service. Still, these mothers ranked 
feeding second as did the non-service 
mothers. Crying was reduced in in- 
tensity for non-service mothers, yet 
they continued to rank it first as did 
the mothers with nursing service. The 
limitation in the study's sampling ap- 
pears to have some influence on this. 
A possible cultural variation in what 
is seen as a concern appeared between 
the two groups before the mothers had 
any experience with their children. 
Some of the non-service group of 
mothers also had "extended visits" 
with their infants in hospital plus ad- 
ditional help in the home, which may 
have influenced their interpretation 
and intensity of concerns. 
JANUARY 1967 


A very important finding in this 
study results from the ranking of in- 
dividuals in terms of "helpfulness." 
There is, in fact, a need to clarify this 
whole area. Mothers in the entire sam- 
ple ranked their husbands first and 
their mothers second in helpfulness. 
Those mothers with public health nurs- 
ing services ranked the nurse third, 
while the non-public health nursing 
group ranked other family members 
third. The question of how a mother 
views help is not answered in this 
study. It is observed. however, that the 
primigravida's husband and mother are 
with her throughout the 24-hour pe- 
riod, and undoubtedly give assistance 
in the care of the baby and home. 
Physician services were used differ- 
ently by the two groups. The mothers 
with public health nursing care con- 
tacted their physicians more often and 
only two in the group were in touch 
with him as many as five times. On 
the other hand, those primigravida 
mothers without service reported con- 
tacting their physicians less often. One 
mother, however, stated that she con- 
tacted her physician 10 times in the 
four weeks. The investigator believes 
that the mothers with nursing care 
used their physician services more 
wisely than the mothers without care. 
Before this conclusion can be made, 
however, further study of this whole 
area of "helpfulness" and what per- 
sons are "helpful" is needed. 
As stated previously, more work is 
needed to improve the sensitivity of 
the study's instrument and its ability 
to discriminate differences. The weight 
assigned by the mother was not ac- 
curately assessed. One mother ranked 
feeding first, but in ranking the scores 
for her, crying was first and feeding 
further down the list. In reviewing her 
responses, it is observed that she had 
fewer concerns about feeding and that 
only one of these did she rate high in 
intensity. This aspect concerned the 
amount of breast milk the baby should 
get. Clearly, the mother ranked this 
above all others. Before using this ins- 
trument in further studies, all non-dis- 
criminating items need to be removed. 


Summary 
The results of this study clearly 
point to a revision of the instrument 
and further study of the concerns of 
primigravida mothers. The addition of 
a third group of mothers who receive 
skilled public health nursing care 
under controlled supervision, plus the 
opportunity of rooming-in with their 
infants in hospital, is also indicated. 
An additional study is the whole area 
of "helpfulness"; how a mother in- 
terprets help; whom she sees as help- 
ful persons; and what they contribute. 


References 
I. Morris, Marian G. The claiming-identi- 
fication processes - their meaning for 
mother-child mental health. Amer. J. 
Orthopsychiat. 25: 303-4, 1965. 
2. World Health Organization. ExperT COIII- 
mittel' on Nursing. Technical Report 
Series, no. 167. Geneva. 1959. 
3. Carpenter, H. et al. An Alwlysi.ç of HOllie 
Visits to Newborn Infants. Toronto, East 
York Leaside Health Unit, 1960. 
4. Hunter, T. et al. Routine home visits to 
newborn infants by public health nurses. 
Can ad. J. Public Health 53: 371-376. 
1962. 
5. Mann, D. et al. Educatin{? Expectant 
Parents. New York, V.N.A. of New 
York, 1961. 
6. Martin, G.K. and Ladd, K.B. Maternal 
and child services, Ontario, 1958. Canad. 
J. Public Health 51: 111-119, 1960. 
7. Shyne, A.W. et al. Servin!? the Ma/emit)' 
Patient ThrouRh Family-Centered Publir 
Health Nursing. New York. Community 
Service Society of New York. 1962. 
8. Adams, Martha. Early concerns of pri- 
migravida mothers regarding infant care 
activities. Nurs. Res. 12: 72-77, 1963. 
9. Seigel. S. Nonparame/ric Stati.ç/ics For 
the Behm';oral Sciences. New York, 
McGraw-HilI, 1956. 0 


THE CANADIAN NURSE 49 



"Project Bed Rest" originated in 
June ] 965 during discussion periods 
in our medical nursing clinics. As in- 
termediate students we were concerned 
about the how, when, what, and why 
of health teaching. We agreed that 
when teaching medical patients our 
emphasis should be on both rest and 
activity. 
First of all we considered the mean- 
ing of "rest" and other terms used to 
describe rest and activity for patients. 
As each of us interpreted "complete 
bed rest" and "bed rest," we realized 
that there was considerable difference 
of opinion regarding what instruction 
should be given to patients. Jf a similar 
confusion of terms existed in the minds 
of doctors, nurses, auxiliary workers, 
and patients, how inconsistent the nurs- 
ing care must be! 
We decided that if guide lines for 
teaching medical patients could be es- 
tablished, this problem might be solv- 
ed. With the help of two of our medical 
nursing instructors, we drew up a plan 
to study the whole subject of rest, to 
define the terms "comp]ete bed rest" 
and "bed rest," and to gain approval 
of the appropriate groups in the hos- 
pitaL Thus, project bed rest was 
launched with an overall objective to 
provide more consistent nursing care 
for medical patients. 
The first task was to clarify the 
purposes of the project. These were: 
]. To provide con!>istent care re- 
garding rest and activity throughout the 
50 THE CANADIAN NURSE 


Project bed rest 


Six enterprising students at the Calgary General Hospital School of Nursing 
conceived, designed and launched a unique plan to make nursing care for the 
medical patient more consistent. 


L. Dahl, M. Smith, B. Fowle, J. Hutchison, R. Graham, and D. Black 


patient's period of hospitalization. 
2. To help the patient understand 
his program of care, participate in it 
and see his progress. 
3. To improve communication 
among doctors, nurses, other staff, pa- 
tients, and patients' relatives. 
4. To aid in the orientation of nurs- 
ing students, new graduates, and other 
staff. 
5. To aid in the teaching of new 
nursing students in the nursing arts 
program. 
The second step in the project was to 
define and clarify the terms relating to 
rest and activity, namely: ]. complete 
bed rest; 2. bed rest; and 3. progres- 
sive activity. 


Steps 10 obtain approval 
To obtain approval for the accept- 
ance and implementation of project 
bed rest, many steps were involved. At 
each level of approval the purposes 
and specific definitions of the project 
were presented in detail. We empha- 
!>ized that staff would not be expected 
to adhere rigidly to the definitions but. 
rather, that each section could serve as 
a guide for all personnel on the health 
team. Alterations as specified by the 
doctor might be required for individual 
patients. 
Since the project was initiated by 
nursing students, the first step was to 
gain the approval of the faculty of 
the school of nursing. The plan for 
rest and activity was presented at a 


faculty meeting. With some minor re- 
visions, it was unanimously and en- 
thusiastically endorsed. The faculty 
suggested that the plan be utilized in 
all clinical areas of the hospital. 
Next, the revised plan was presented 
to the director of nursing service, 
supervisors, and head nurses at a staff 
meeting. Also present at this meeting 
was a consultant cardiologist who had 
expressed interest in project bed rest 
and had offered helpful suggestions, 
especially in defining progressive acti- 
vity. Again, the plan was readily ac- 
cepted and approved for all clinical 
areas. 
Having received support from the 
faculty and all nursing service person- 
nel, we next sought the approval of the 
hospital administrator. He reviewed 
the plan several times and made some 
very helpful suggestions. 
The final step was to present the 
plan to the medical advisory com- 
mittee. The administrator explained the 
proposed plan to the committee, and 
its members gave us enthusiastic sup- 
port and approval. 


Implementation 
Project bed rest was now ready 
to be implemented. The responsibility 
for making the plan operational was 
accepted by a nursing service commit- 
tee under the chairmanship of a head 
nurse. The written material was dis- 
tributed to all nursing units and to 
staff doctors. Individual copies of the 
JANUARY 1967 




 


. 


- - 


. 
,. 


\ 
;\
 


1 


- 


... 


I 
-\ 
,," -!I'
: .f 


-- ' 
,,' J 
i 
 . t 
\' 
.
 



 



 


particular phase or phases of rest 
ordered were given to patients with 
verbal explanations. All groups con- 
cerned with the project recognized that 
the guide lines would have to be inter- 
preted to new staff, as well as to in- 
coming patients, if project bed rest 
were to be successful. 0 


\....... 


Complete Bed Rest 
1. To stay in bed at all times. 


Bed Rest 


2. a. To be fed. 
b. To restrict movements. 


I. To stay in bed at all times. except for use of commode 
chair. 


3. To be bathed every second day or p.r.n. (minimal 
linen change) 
To have total mouth care after meals. 
To have hair shampoo once per week, if ordered, in 
bed. 


2. To feed self; food must be set up. e.g.. meat cut. bread 
buttered, etc. 
3. To be bathed. but may wash face, hands and finish 
bath. 
To remain in bed while linen is changed. 
To give self total mouth care after meals. 
To have shampoo weekly. if ordered, in bed. 
4. To shave self. 
To apply own cosmetics. 
5. To have half-hour rest periods between 2, 3, and 4 
above. 


4. To be shaved. 
To have cosmetics applied. if desired. 
5. To have half-hour rest periods between 2, 3. and 4 
above. 


6. To be turned q.2h. as tolerated, and raised up in bed 
by staff (lifting sheet required, e.g., sheepskin). 
7. To have passive movements b.i.d. to all joints for 5 
minutes and deep breathing exercises q.lh. (10-12 deep 
breaths). Should wiggle toes, fingers, feet, wrists, q. Ih. 
8. To have visitors restricted to immediate family (5 min.). 
one at a time. 


6. To turn self by rolling from side to side like a log; 
must be assisted when raising up in bed. 
7. fo initiate active movements b.i.d. to all joints, for 5- 
minute periods. 
To take deep breathing exercises qlh. 
8. To have visitors restricted to immediate family (15 
min.). 
9 To be lifted into commode chair at bedside for bowel 
movements. 


9. To use bedpan (slipper pan); should be assisted by two 
people. Males to use urinal in bed. 
10. a. To have reading material propped. 
b. To operate radio. 


J O. a. To hold books, etc. 
b. To operate radio 
nd T.V. 
J I. To have a "call" light within easy reach at all times. 
12. To be checked at regular intervals by the nurse. 


I 1. To have a "call" light within easy reach at all times. 
12. To be checked at regular intervals by the nurse. 


JANUARY 1967 


THE CANADIAN NURSE 51 



Progressive Activity 


Day Bath every 2 days 
or p.r.n. 
With help. Legs, feet, and 
back to be done by nurse 
2 With help 
3 With help 


4 With help 


5 With help 


6 May bathe self in bed. 
Shampoo if ordered. 
7 May bathe self in bed. 
Shampoo if ordered. 
8 May bathe self in bed. 
Shampoo if ordered. 


9 May bathe self in bed. 
Shampoo if ordered. 


10 May bathe self in bed. 
Shampoo if ordered. 
I I Wash self in bath-room. 


12 Wash self in bath-room. 


Elimination 


Commode at bedside for BM's 
(lifted). 
Use bedpan, urinal for voiding. 
Commode at bedside for BM's 
(lifted). 
Use bedpan, urinal for voiding. 
Commode at bedside for BM's 
(lifted). 
Use bedpan, urinal for voiding. 
Commode in BR for BM's, use 
bedpan or urinal for voiding. 
Commode in BR for BM's, use 
bedpan or urinal for voiding. 
Commode in BR for everything. 


Commode in BR for everything. 


May walk to bathroom once 
daily. 
Commode in bathroom other 
times. 


May walk to bathroom twice 
daily. 
Commode other times. 


May walk bathroom three times 
daily, commode other times. 


See "walking." 


I 


Sitting 


, 


Walking 


Nil 


Nil 


Nil 


Nil 


Nil 


2 or 3 steps to chair b.i.d. (as- 
sisted) . 
5 or 6 steps to chair (assisted). 


30 min., b.i.d., chair in room. Walk to chair b.Ld. and walk 
to bathroom once daily (if 
BR within 10 yards of bed). 
35 min., b.i.d., chair in room. Walk to bathroom twice daily. 


Walk to bathroom three times 
daily. 
Walk to bathroom four times 
daily. 


Increase walk to bathroom once 
daily then walk in corridor and 
up and down stairs as ordered. 


52 THE CANADIAN NURSE 


JANUARY 1967 


Dangle 5 min. b.i.d. 


5 min., chair at bedside (lifted). 


5 min., b.i.d., chair near bed- 
side (self-assisted). 


10 min., b.i.d., chair near bed- 
side (self-assisted). 
15 min., b.Ld., chair near bed- 
side (self-assisted). 
20 min., b.i.d., chair near bed- 
side (see "walking"). 


25 min., b.i.d., chair in room. 


40 min., b.i.d. 


45 min., b.i.d. 


Increase chair 5 min. daily. 



books 


Pediatric Nursing by Audrey J. Kalafatich, 
R.N., M.S.N. 432 pages. New York. 
G.P. Putnam's Sons, 1966, 
Reviewed by Miss Nell Joiner, assista1lt 
professor, maternal-child nursing, Me- 
morial University of Newfoundland 
School of NursinR, St. John's, Nfld. 


fhe author states in the preface that her 
aim is to give some insight into the care 
of the "whole child." The format of the 
text follows the usual sequence of delineat- 
ing care of the child from birth through 
adolescence according to developmental 
tasks and needs peculiar to specific develop- 
mental levels. Throughout the text, brief 
reference is made to common diseases and 
disorders according to age levels, with treat- 
ment and nursing care following each condi- 
tion. General principles of nursing care are 
outlined but never developed in breadth and 
depth. 
Unit I is extraordinarily brief and 
vague in presenting a frame of reference 
for quality nursing care based on un- 
derstanding of the child as a person in a 
given point of time with a specific problem 
and as a member of a family constellation. 
The reference to the importance of relation- 
ships and interrelationships in pediatrics 
follows the same generalization. It would 
have been better to omit this entirely rather 
than to confuse the issue with superficiality 
and vagueness. 
Units II through VI deal with the cycle 
of childhood from birth through adoles- 
cence. The discussions of treatment and nur- 
sing care seem more of a condensed resume 
with sweeping generalizations, rather than 
broad principles upon which to base and 
plan individualized nursing care. I find the 
discussions that are devoted to nursing care 
disappointingly brief and inadequate. An 
example of this brevity appears on page 
218, where the author devotes a three- 
sentence paragraph to the treatment and 
care of the infant with cerebral palsy. 
Another example of brevity appears on 
page 413: "The pre- and postoperative care 
that accompanies the spinal fusion will not 
be given in detail since it is essentially the 
same as for an adult patient with a solid 
fusion of the spine." By a swift stroke of a 
pen, the author moves to something else 
without pointing out the similarities and 
differences. It would seem that she is as- 
suming that the student has sufficient prior 
knowledge and experience to make the 
necessary adaptations in planning care for 
the adolescent with a spinal fusion. 
,ANUARY 1967 


Some of the information on treatment 
and nursing care is unclear and, consequent- 
ly, open to misinterpretation. An example 
of lack of clarity appears on page 180 in 
whIch the author states that "an elevated 
temperature raises the body's need for oxy- 
gen and metabolism." Here she treats an 
adaptive bodily process, metabolism, in the 
same order as the body's need for a life- 
sustaining substance, oxygen. What is she 
trying to convey - the body's reaction to 
an elevated temperature, the increased need 
for oxygen to meet the demands of speeded 
up cellular activity, or what? 
This book falls far short of presenting 
any real insight into the care of the "whole 
child" and does not support the thesis that 
the book is primarily concerned with nur- 
sing care. Brevity, sweeping generalizations, 
and vagueness are its chief characterictics 
and weaknesses. It may have some value 
as a handbook for quick, brief references, 
but limited value as the text of choice for 
basic students in professional nursing. 


Fundamentals of Research in Nursing 
by David J. Fox, Ph.D. 285 pages. New 
York, Appleton-Century-Crofts. 1966. 
Reviewed by Miss Kathleen A. Dier, as- 
sistant professor, School of Nursing, Un i- 
J'ersity of Saskatchewan, Saskatoon, 
Saskatchewan. 


The stated purpose of this book is to 
prepare the nurse to be an "intelligent, criti- 
cal consumer of research." The author ex- 
plains that the skills needed to understand 
and use research are different than those 
needed to do research. It is intended to 
help nurses evaluate the research now being 
produced. not only in nursing but in relat- 
ed social sciences as well. Dr. Fox is well 
prepared for this assignment as he teaches 
an introductory course in nursing research 
at Columbia University, New York. 
The book is divided into five major areas. 
The author begins by describing a project 
that he conducted, then deals in detail 
with the 17 steps required in the planning 
and implementing of this study. He proposes 
a model that should help identify areas for 
further research in nursing. It is stated that 
nurses have a unique contribution to make, 
providing they concentrate on problems 
related to nursing. However, Dr. Fox is 
also in favor of interdisciplinary research 
where the nurse is a member of the investi- 
gating team. 
The second area is mainly devoted to 


statistical procedures that the author believes 
must be comprehended before the principles 
of research can be understood. The rationale 
of statistics is given without any of the com- 
plicated formulae. Even though this section 
is clearly written with practical examples 
taken from nursing, some of the concepts 
might be hard to grasp if the reader has 
no previous knowledge of statistical 
methods. The section on sampling is excel- 
lent. 
The fourth area deals with the various 
types of research and the methods of 
gathering data. Here, the issue of ethics 
in nursing research is raised and I would 
heartily agree that this is a problem that 
must be faced soon by our profession. 
In the fifth section, the nurse is advised 
how to evaluate the written report. It is 
truly stated that where research is concerned 
nurses have been "a polite, uncritical and 
largely unresponsive audience." Dr. Fox 
urges nurses to make more use of good 
research findings and actively reject those 
that are poor. This is the only way that the 
product will be improved. 
I believe the author has achieved his 
objective by presenting rather complex 
research methodology in a simple, straight- 
forward manner. It could be a valuable 
reference for leaders in nursing and students 
in university, since it contains many ideas 
for nursing studies and an excellent reading 
list. Although it is not light reading, I 
would recommend this book to all nurses 
who wish to become intelligent participators 
in the changes now taking place in our pro- 
fession. 


Basic Concepts in Anatomy and Physiology 
by Catherine Parker Anthony, R.N., B.A., 
M.S. 132 pages. Saint Louis, Mosby, 1966. 
Rn'iewed by !'vlrs. Jean Magee, instructor 
of anatomy and physiology, Victoria 
General Hospital School of Nursing, 
Halifax, Nova Scotia. 


To review this book objectively, I had to 
supplement my knowledge of programmed 
instruction. In so doing, I reversed a rather 
unfavorable first opinion to one of great 
enthusiasm. 
The author has achieved her expressed 
purpose to produce a programmed text that 
would be used as a "supplement and not 
as a substitute for a conventional textbook." 
She states in the preface that "the book 
will have greatest value for students wanting 
10 acquire or review basic information or to 
(Continued on page 54) 
THE CANADIAN NURSE 53 



WOO@ says 
life at Mary Fletcher 
Hospital Medical Center 
is all work & no play? 
Uncrowded Vermont is for ..... 
those who like outdoor tJn. r" 
Saili
g, swimmin
 skiing, 
tenms, golf, are only lI)in. ..v 
utes away from Mary Fl1;t. 
cher Hospital on the shor: 
of lovely Lake Champlain. 
Combine an exciting career 
with off-duty recreation and 
the cultural advantages of 
an attractive college com- 
m unity. Excellent startin' 
salaries, liberal fringe bene: 
fits, clinical affiliation with 
Univ. of Vermont College of 
Medicine. MFH serves as the 
primary teaching and refer. 
ral center for all of northern \ 
New England. 
r------------- 
 
Personnel Office, Dept. 401 
Mary Fletcher Hospital Medical Center I 
Burlington, Vermont 05401 I 
Please tell me more about career opportuni- I 
ties at Mary Fletcher Hospital Medical Center I 
and send me literature about Vermont - I 
The Beckoning Country. I 
I 
NAME I 
I 
ADDRESS I 
I 
I 
-------------------
 


IN CAPS AND GOWNS 
THE STORY OF 
THE SCHOOL FOR 
GRADUATE NURSES 


McGill UNIVERSITY 
1920 - 1964 


. . provides vignettes of the devoted 
and far-seeing women who toiled to 
develop the School ... An amazing 
feature of this book is the warm and 
engaging style which emerges ... A 
handsomely produced volume." 


THE MONTREAL STAR 


A vailable by mail or in person 
c/o 


SCHOOL FOR GRADUATE NURSES 


3506 University Street 
Montreal r P.Q. 


PRICE: $6.50 per copy 


54 THE CANADIAN NURSE 


books 


(Co/ltinued from page 53j 


clarify difficult concepts about the human 
body." 
Information in sequence is presented in 
small steps (frames) that require frequent 
responses by the student. Miss Anthony 
chose to use the classical linear form type 
of frame developed by Skinner at Harvard 
University, rather than the branching or 
multiple-choice frame. Early frames in each 
unit set forth simple, easy concepts of the 
subject material. 
If the reader chose only to read the begin- 
ning questions in each unit, she would 
probably conclude that the entire book was 
too elementary for students of nursing. 
Questions in the early frames tend to be 
redefinitions of what has been previously 
stated, and a simple glance upward supplies 
the missing word. However, as the frames 
progress, there is also a step-by-step progres- 
sion in the complexity of subject matter. 
The reader finds herself actively reading 
and responding to highly complex concepts 
without realizing their complexity. 
In this text, immediate feedback is given 
to the student to inform her whether her 
response is correct. The student need waste 
little time and effort confirming her res- 
ponses as the correct answer is found to 
the left of each frame. Thus, if she answers 
correctly, she progresses to the next fact. 
If she does not understand, she can be 
helped immediately. 
In summary, this book will be a chal- 
lenge to those who teach anatomy and 
physiology in schools of nursing. It could 
prove helpful as an aid to all students, in 
particular, to those students who have dif- 
ficulty grasping principles in this subject. 


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Elementary Textbook of Anatomy and Phys- 
iology Applied to Nursing by Janet T.E. 
Riddle, R.G.N., R.F.N., O.N.C. 151 
pages. Toronto, MacMillan of Canada, 
1966. 
Reviewed by Sister Frances L. Rooney, 
assistant administrator, Holy Family Hos- 
pital, Prince Albert, Sask. 


In spite of the brevity of this text, es- 

ecially in the content about physiology, it 
tS a very practical presentation, and should 
be of particular value to nursing assistants 
and technicians. Each system is presented 
concisely, and the book concludes with a 
valuable chapter on "Posture - Nurse and 
Patient. " 
The chapter on the digestive system is 
incomplete, but the chapter on the respir- 
atory system is excellent. Accompanying 
illustrations are good. Anyone studying 
anatomy and physiology will find the review 
questions at the end of each chapter very 
practical, especially in reference to an- 
atomy. 
This book is, as the author states "a 
simple overall picture of the human b
dY" 
and as such should be of value to a nurse 
looking for a quick review, or the beginning 
student who requires only very elementary 
knowledge of the subject. 


In Caps and Gowns by Barbara Logan 
Tunis, B.N. 154 pages. 1966. Montreal, 
McGill University Press. 
Reviewed by Miss Margaret E. Kerr, Apt. 
1403, 150 -24th Street, West Val/couver, 
B.C., formerly executive director and 
editor of The Canadian Nurse. 


The significance and importance of uni- 
versity education for professional nurses has 
been so strongly emphasized over the past 
few years that it is difficult to realize that 
50 years ago, even 40 years, it was practi- 
cally an unknown quantity in Canada. Grad- 
uates of the past two or three decades 
scarcely can imagine a time when Canadian 
universities. through their Boards of Gover- 
nors, flatly refused to recognize the desire 
or the need for any programs for nurses. 
Today, the strong emphasis on advanced 
preparation is a keystone of policy in the 
Canadian Nurses' Association. The findings 
of the Royal Commission on Health strength- 
en the CNA platform. Why was nursing 
for so long an unwanted stepchild of higher 
education? 
This question and many others of a simi- 
lar nature are answered in this history of 
the development of the School for Graduate 
Nurses of McGill University. Out of her 
very thorough research of old records. her 
interviews and correspondence, and her per- 
sonal knowledge as a member of the first 
class to receive a B.N. degree from Mc- 
Gill. Mrs. Tunis has woven a wondrously 
interesting history that merits the attention 
of today's generation of nurses. 
The close of World War I marked a 
JANUARY 1967 



books 


turning point in medical care. The change 
of emphasis from strictly curative to broad- 
ly preventive program
 brought with it a 
growing demand for nurses who were quali- 
fied to go into the homes. the schools, and 
industries to teach the fundamentals of good 
health. Preparation for these new duties was 
not included in the curricula of many of 
the "training schools" of that day. It seemed 
logical, therefore, that the leaders in nurs- 
ing should turn to the traditional sources 
of higher education - the universities - 
for guidance and assistance in developing 
the essential cour
es. Unhappily, organized 
nursing had not yet set its own educational 

tandards either for admission to schools 
or for the programs of instruction provided. 
Thus, it was inevitable that there should be 
difficulties in persuading universities of the 
validity of the requests for a place to be 
found within the university for nursing 
programs. 
That the original committee of nursing 
leaders in Montreal was able to achieve an 
initial goal by 1920 is a tribute to their 
dogged perseverence. With three different 
certificate courses established, student en- 
rollment flourished. Financially, there were 
always problems to maintain the School, so 
the sharp depression of the thirties came as 
a shuddering, almost fatal blow. 
It was then that the active Alumnae As- 
sociation, by a herculean effort, with Miss 
E. Frances Upton leading the way, raised 
the necessary funds. 
Throughout her history, Mrs. Tunis has 
given us many intimate biographical sketches 
of the people who have brought the School 
to its present stature. For these alone, In 
Caps and Gowns is worthy of interested 
reading. Through them she has portrayed 
not only their contributions to the School 
for Graduate Nurses but also an insight into 
the development of our own Canadian 
Nurses' Association. 
We strongly recommend this history to 
instructors in our schools of nursing, to 
graduate nurses everywhere, and of course 
to those nurses who have been privileged 
to participate in any of the programs of 
study that are provided. 


Annototed Bibliogrophy on Childhood 
Schizophrenia 1955-1964 by James R. 
Tilton, M.S., Marian K. DeMyer, M.D., 
and Lois Hendrickson Loew, M.S. 136 
pages. Toronto, Ryerson, 1966. 
Re
'iewed by Mrs. E.M. Pollard, nursing 
administrator, Sherwood Hospital, Char- 
lottetown, P.E.I. 


rhe object of the authors has been to 
provide a comprehensive SOurce of reference 
to the English-language writings on child- 
JANUARY 1967 


hood schizophrenia for the period 1955 to 
1964. 
The book is subdivided appropriately into 
seven sections: historical and general review 
articles; descriptions and diagnosis; etiology; 
biochemical, neurological, and physiological 
studies; family characteristics; treatment and 
care; and follow-up studies. In each section 
the annotations of the books and papers are 
concise and clear-cut. 
This bibliography should save many hours 
of searching through library shelves, as the 
books and periodicals listed are readily 
available in the libraries of psychiatric 
units. The objective of the authors has been 
accomplished. 


films 


Pharmacology 
Drugs and the Nervous System is a 
recently-released film showing the effects 
of drugs on organs and body systems. 
Aspirin is used to demonstrate how a drug 
works, but considerable emphasis is placed 
on the abuse or misuse of certain drugs, 
such as stimulants (amphetamines), depres- 
sants (barbiturates, opiates), and halluci- 
nogens (marijuana. LSD). 
The film is in color and runs for 16 
minutes. FuU information can be obtained 
from Churchill Films. Educational Film 
Distributors Ltd., 191 Eglinton Ave. E., 
Toronto 12, Ontario. A rental fee is charged. 


Cardiac arrest 
The Nurse in Emergency Cardiopulmonary 
Resuscitation, a 16 mm., 15 minute, color, 
sound film, was released in faU 1966. It 
shows a hospital patient in acute cardio- 
pulmonary distress and emphasizes the 
nurse's function and responsibilities from 
the initiation of resuscitation through to 
transfer of the patient to the care of the 
physician. 
The film would be especially useful in 
inservice education programs, and for show- 
ing in schools of nursing. It is available on 
loan from the Canadian Heart Foundation. 
1130 Bay Street, Toronto 5, Ont. 


Arthritis 
Rheumatoid Arthritis is a new, 30-minute, 
color, sound film designed primarily for the 
physician. However, it contains considerable 
information on aspects of this complex 
disease process that would be of considerable 
interest to student nurses and to graduate 
nurses working with patients suffering from 
these diseases. 
Etiology, diagnostic methods, and recent 
advances in treatment are demonstrated. 
Typical arthritic forms in the adult are 
shown and the development from monar- 
thritis to polyarthritis. 
The film may be borrowed from Film 
Library, Pfizer Company Ltd., 50 Place 
Cremazie, Montreal II, Quebec. 


Next Month 
in 


The 
Canadian 
Nurse 


Estrogens 
and the 


menopause 


Care of 
patients 
with 
skin cancer 


Drug addiction 
- research, 
treatment, and 
nursing care 



 

 


Photo credits 


Dominion-Wide, p. 8. 


Cerebral Palsy Assoc. of 
Quebec, p. 31. 


National Hcalth and Welfare, 
pp. 44, 51. 


Miller Services, Toronto, p. 47. 


THE CANADIAN NURSE 55 



'\
ORKSIIOPS FOR 


DIRECTORS AND 



 

 


i\.SSIST ANT DIRECTORS 


SiK regionol workshops for directors or ossistant directors of nursing service in hospitals 
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through 
the problem-Solving Method. 
The workshops aim at stimuloting directors and assistant directors of nursing service to use 
the problem-solving approach in the odministrotion of nursing services. Key speakers will 
discuss techniques of problem-solving. Major problems in nursing services in Canada will be 
discussed. Through group work and case study methods skills in problem-solving will be 
developed. 


Two workshops will be 
Region 
Atlantic 
West 
And four In the Fall: 
Region 
Ontario 
Mid-West 
Ontario 
Quebec 


held in the Spring: 
City 
HalifaK 
Vancouver 


Dote 
April 11-14, 1967 
May 2.5, 1967 


City 
Toronto 
Regina 
London 
Quebec City 


Dote 
October 17-20, 1967 
October 24-27, 1967 
November 7-10, 1967 
Nov. 28-Dec. 1, 1967 


EKact locations will be onnounced later. 
The workshop to be held in Quebec city will be conducted in the French language only. 
English longuage nurses in the province of Quebec ore invited to ottend one of the work- 
shops held in Ontorio. French language nurses in New Brunswick are invited to attend the 
workshop in Quebec city. 
The workshops are open to directors or assistant directors of nursing service in hospitals. 
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature 
of the workshop only full-time registrants can be accepted. 
Here is an opportunity for directors and assistant directors of nursing service: 
. to sharpen skills in problem-solving within a 
"training laboratory" environment; 
. to leorn how problem-solving can be facilitated through group work; 
. to stimulate orderly thinking toward the improvement of 
nursing service; 
. to identify the leadership role of the director of nursing service 
and/or assistant director of nursing service in problem-solving and 
decision making. 
Interested! then plan now to attend the workshop in your area. Register early and avoid 
disappointment. 


I wish to register for the CNA Regional Workshop for Directors or 
Assistant Directors of Nursing Service in Hospitals held in : 
o Halifax 0 Regina 
o Vancouver 0 London 
o Toronto 0 Quebec City 


Name 


Title of Position 
Name of Hospital 
City or Town 
Qualifications beyond RN 
I enclose postal note (bank money order) for $ 
payable to the Canadian Nurses' Association. 


Years in Position 


Number of Beds 


MAIL TO: 
CANADIAN NURSES' ASSOCIATION 
50 The Driveway 
Ottawa 4, Ontario 


56 


THE CANADIAN NURSE 


accession list 


Publication
 in this list of material 
received recently in the CNA library are 
\hown in I,mguage of source. The majority 
(reference material and theses. indicated by 
R excepted) may be borrowed by CNA 
member
. and by libraries of ho\pitals and 
\choo]
 of nursing and other institutions. 
Requests for loan\ should be made on the 
"Reque\t Form for Accc\\ion Li\t" (page 
58) and should be addre
sed to: The Li- 
brary. Canadian Nurses' Associ,nion. SO 
The Driveway. Ottawa 4. Ontario. 


BOOKS AND DOCUMENTS 
I. Basic COllceptS ill lIlIatomy alld phy- 
\'/ology by Catherine Parker Anthony. St. 
Louis. Mosby. 1966. 133 p. 
2. Bibliograp/'ical procedures alld style by 
Hlanche Pritchard McCrum and Helen Du- 
denbostel Jones. Washington. Library of 
Congress, 1954. ] 33 p. 
3. Calladiall quotatiolls ami phra.res, liter- 
ary alld historical by Robert M. Hamilton. 
Toronto. McClelland and Stewart. ] 952. 
272 p. R 
4. Cvmmullity colleges ill Callada, Na- 
tion,.1 seminar on The Community College 
in Canada. May 30, 31. June I. 1966. To- 
ronto, Canadian Association for Adult Edu- 
cation, 1966. 109 p. 
5. Colltilluity of patiellt care: the role of 
lIunillg by K. Mary Str,lUb and Kitty S 
Parker. Washington. Catholic Univer
ity of 
American Press. c] 966. 232 p. 
Ii. The dc.\criptÏ1'e catalogillg vf library 
mCllaials, 2d ed. rev., by Shirley L Hop- 
kin
on. S,m Jose. Calif., Claremont House, 
c1966. 78 p. 
7. Ecollomic comequellces of the profes- 
rioll.f by D.S. Lees. London. Institute of 
Economic affairs. 1966. 48 p. 
8. Education studies in progress in Can- 
adian //IIi\'ersilies 1965 by the Canadian 
Education Association Research and Infor- 
mation Division. Toronto. 1966. 210 p. R 
9. Essentials of chemistry by Gretchen O. 
Luros and Jack C. Towne. Philadelphia. 
Lippincott. c1966. 356 p. 
01'10. The foundations of nursing as cvn- 
ceil'ed, learl/ed, and practiced in profes- 
.fiol/al I/ursil/g by Lillian DeYoung. SI. 
Louis, Mosby, 1966. 279 p. 
I I. FUI/damentais of public health I/ursing 
by Kathleen M. Leahy and M. Marguerite 
Cobb. New York. McGraw-Hili. c1960. 225 p. 
12. Group psychotherapy in nurs/llg prac- 
tice by Shirley W. Armstrong and Sheila 
Rouslin. New York. MacMillan. c1963. 170 p. 
13. l.fSue.f i/l /lursil/g by Bonnie Bullough 
and Vern Bullough. New York. Springer. 
c1966. 278 p. 
14. The leader and the prOCe.fS of change 
by Thoma
 R. Bennett, New York. A\
oci,l- 
tion Pre
s, c1962. 63 p. 
15. The life of Florel/ce Nigl1tingale by 
Sarah A. Tooley. New York. MacMillan. 
JANUARY 1967 



accession list 


london. Bousfield. 1905. 344 p. 
16. !llaterni1\' care ill the wurld: mterna- 
tional survey of mid\\-ifery practice and 
training. Report of ,I Joint Study Group 
of the International Federation of Gynae- 
cology and Ob
tetrics and the International 
Confederation of Midwive
. Oxford. Perga- 
mon Pre
s. c 1966. 527 p. 
17. No mall stallds alolle by Amy V. Wil- 
,on. Sidney. B.C'.. Gray. 1966. c1965. 138 p. 
18. Nllr.fe ph\'siciall collaboratioll toward 
Ùllpl'ol'ed patiellt care. Papers from National 
Conference for Professional Nur
e
 and Phy- 
sicians. 2d. Denver. Col., Sept. 3D-Oct. 2. 
1965. sponsored by The American Medical 
A

ociation and The American Nur
ð As- 
sociation. New York. American Nurses As- 
sociation. c 1966. 63 p. 
19. N ur.fÏllg care plalls. Study program in 
nursing management by the American Ho
- 
pital Association. Hospital Research and 
Education Trust. Chicago. American Hos- 
pital Association. 1966. 77 p. 
. 20. The lIursillg prufeHioll: fil'e mciol- 
ogical essays by Fred Davis. New York. 
Wiley. c1966. 203 p. 
21. The lIursillg senice mallual of policies 
alld wor/..illg relatiolls 3d ed. prepared by 
St. Francis Hospital. Wichit:!. Kansas. St. 


loui
. Catholic Ho'pital Association. 1964. 
Iv. 
22. Opilli01/f de sept groupes de perSUlllles 
ell COli tact al'ec l'C'tudiaute illfirmière par 
rapport a des comportement, généralement 
dé,irables ou inacceptable, par Soeur Jeanne 
Fore
t. Montréal. 1966. Thesis - Olla\\-a R 
23. Piuurc: \OlIri es. 2d ed.. by Cele
tine 
G. Frankenberg. New York. Special Librarie
 
A
sociation. c 1964 216 p. R 
2
. A 1'1011 for imlerillg the periudical 
literature of lIursillg by Vern M. Pings. New 
York, American Nur
es' Foundation, c1966. 
:!02 p. 
25. Proce.';illg ma/1//(/I: a pictori,tI work- 
book of cat,llo
 cards by Althea Conley 
Herald. Teaneck. New Jersey. Fairleigh Di::- 
kinson University Pre
s. 1963. 88 p. 
26. Relwhilitatioll cellter pl(lllllillf! (III or. 
chitectural guide by Cuthbert A. Salmon and 
Christine F. Salmon. University Park. Penn.. 
Pennsylvania State University Press. 1959. 
1964 p. 
27. Studellt Ilune I,'a,'tage by General 
Nursing Council for England and Wales. 
London. 1966. 48 p. 
28. A stlldv of programs ill selected 
fe/IOOls of lIursillf! to determille the liberal 
edllcatioll coutellt of the curriculum with 
specific referellce to learnillg experiellces 
related to lIursill!! of the af!ed by Frances 
Edith Bell. London. 1966. 175 p. Thesis 
(M.Sc.N.) - We
tern Ontario R 


29. A study of the relatiollship betweell 
tI,e predictioll of succefS ill a school of 
lIursillg alld c1illical performallce by Jeanne 
Dolores Zelech. Se,lItle. 1966. 87 p. Thesis 
(M.N.) - Washington. R 
30. Ta/..ill!! the hospital to the patieut; 
home care fur the small COllllllllllity by John 
R. Griffith. BailIe Creek. Mich.. W.K. Kel- 
logg Foundation, 1966. 55 p. 
31. Teachillg alld Admillistratioll ill Nurs- 
in!! Associate Degree Prograllls. Second 
Seminar. Purdue University. July 18-30. 
1965. Report. Layfelle. Indiana. Purdue 
Univer,ity, Dept. of Nursing, 1965. 49 p. 
32. TeHboo/.. of allatomy Gild phyÛology 
for Ilunes by Diana Clifford Kimber and 
Carolyn E. Gray. 5th ed. rev. New York. 
MacMillan. 1919. 527 p. 
33. Todav alld tomorrow ill we.'terfl flllrs- 
ÙI!! by Western Interstate Commission for 
Higher Education. Bolder. CoI.. 1966. 108 p. 


PAMPHLETS 

4. ApprOl'ed medical-Illlne plocedllres 
by Registered Nurses' As
ociation of Nova 
Scotia. Halifax. 1966. 
35. A guide for staff educatioll alld staff 
dl'l'elopmellt by the Regi
tered Nur<;cs Asso- 
ciation of Ontario. Commillee on Nur
ing 
Service. Toronto. 1966. 6 p. 
36. A guide to iuterl'iewillg alld cuulHeI- 
illg for the lIurse ill illdustry by the American 
Association of Industrial Nurses. Committee 


\r 


tur (f JlOrectfl! 
rOll/lort 
thflt {fistS! 


meet the patient's needs with 


ANUSOL 


Hemorrhoidal Suppositories and Ointment 


SAFE: Anusol contains no 
analgesics or narcotics and will 
not mask the symptoms of serious 
rectal pathology. 



 


'r 


\ 


.. 



 


( 


I 


CHASE 
HOSPITAL 
DOLLS 


For demonstrating and practicing the 
newest nursing techniques . lavage and 
gavage . tracheotomy and colostomy, 
and their post-operation care . nasal 
and otic irrigations . catheterization and 
all abdominal irrigations . subcutane- 
ous, intramuscular and intradermal injec- 
tions . and all standard nursing procedures. 
Let us tell you about the new features we 
have added to this world-famous teaching 
aid. Write to 
M. J. CHASE Co. Inc. 
Pawtucket 


. 


- 


WARNER-CHILCOTT I EÐ I 
laboratories Co. limited, Toronto, Canada we 
Makers of Tedral.Brondecon, Choledyl 


JANUARY 1967 


156 Broadway 
Rhode Island 


THE CANADIAN NURSE 57 



accession list 


on Education. New York. American Asso- 
ciation of Industrial Nurses. 1960. p. 21-28. 
(Reprint) R 
37. A guide to till' respullsibilities alld 
qualificatiolls for mriulls positiufl.f ill IIl1rs- 
illg .fenice by the Registered Nurses Asso- 
ciation of Ontario. Committee on Nursing 
Education Sub-Committee on Basic Oegree 
Programs. Toronto, 1966. 2 p. 
38. A gllide to tile respollsibilities and 
qualificationf for "uriolls positions in nllrs- 
ing .ferl'ice by the Registered Nurses Asso- 
ciation of Ontario. Committee on Nursing 
Service. Toronto. 1966. 8 p. 
39. How to IIse YOllr lihrary by Harold 
S. Sharp. New York. Consolidated Book 
Service. c1963. 17 p. 
40. Preselllatioll 011 nllrsing needs for 
Prince Edward Island. Brief to the execu- 
tive council of the Prince Edward Island 
Government by the Association of Nurses of 
Prince Edward Island. Charlottetown, 1966. 
10 p. 
41. A teacllillg guide to science and cancer 
by Ralph P. Frasier and others for the 
National Science Teachers Association. 
Washington. U.S. Oept. of Health. Educa- 
tion and Welfare. Public Health Service. 
1966. 24 p. 


42. T eaclltllg melltal IIealtll in tire basic 
uursing program by the Registered Nurses 
Assocication of Ontario. Committee on Nurs- 
ing Education. Toronto, 1966. 10 p. 


GOVERNMENT DOCUMENTS 
Canada 
43. Illternal migratioll ill Callada, 1921- 
1961 by Isabel B. Anderson. Ottawa, Eco- 
nomic Council of Canada, 1966. 90 p. 
44. Assllrallce médicale pril'ée et paiement 
par alllicipatioll par Charles H. Berry. Ot- 
tawa, Imprimeur de la Reine, 1966. 255 p. 
(Commission royale d'enquête sur les ser- 
vices de santé.) 
45. Tile cOlllributioll of edllcation to eco- 
nomic growtll by Gordon W. Bertram. 
Ottawa, Economic Council of Canada, 1966. 
150 p. 
SasJ..atcllewall 
46. Oept. of Public Health. Ad hoc Com- 
mittee on Nursing Education. Report. Re- 
gina, Queen's Printer, 1966. 226 p. 
United States 
47. Bibliographic aspects of medlars by 
Seymour I. Taine. Washington, U.S. Public 
Health Service; Reprint from Bull. Med. Lib. 
Assoc. v. 52, no. I, Jan. 1964. p. 152-/57. 
48. Dept. of Health, Education and Wel- 
fare. Public Health Service. Focus resources 
ill school health services. Washington, U.S. 
Govt. Print. Off., 1966. 20 p. 
49. Dept. of Health, Education and Wel- 
fare. Public Health Service. Health mall- 


power source book, sectioll 2, Nursing per- 
sOllllel. Washington. U.S. Govt. Print. Off., 
1966. 113 p. 
50. Oept. of Health, Education and Wel- 
fare. Public Health Service. How to be a 
nurses' aide ill a nursing home; instructor's 
mallual. Washington, U.S. Govt. Print. Off., 
I 966. 20 p. 
51. Oept. of Health. Education and Wel- 
fare. Public Health Service. Occupational 
melllal IIealth: all emerging art. Washington, 
U.S. Govt. Print. Off.. 1966. p. 961-976. 
52. Oept. of Health, Education and Wel- 
fare. Public Health Service. Pllblic Health 
service film catalog 1966. Washington, U.S. 
Govt. Print Off.. 1966. 99 p. 
53. Oept. of Health, Education and Wel- 
fare. Public Health Service. Traillillg pro- 
f!rams of the Natiullal ll1stitttte of Melltal 
Health. Washington, U.S. Govt. Print. Off., 
1966. 21 p. 
54. Desigll features affectillg asepsis ill 
tile hospital by Richard P. Gaulin. Rev. 
Washington, U.S. Oept. of Health, Edcation 
and Welfare. Public Health Service. 1966. 
10 p. 
55. National Library of Medicine. Cllm- 
ulated index medicus, 1965. Washington, 
U.S. Govt. Print. Off.. 1966. 4 pts. R 
56. Occupatiollal health IIl1nes: all initial 
slln'ey by Mary Lou Bauer and Mary 
Louise Brown. Washington, U.S. Oep!. of 
Health, Education and Welfare. Public 
Health Service, 1966. 146 p. 


Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 


Send to: 
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Please lend me the following publications, listed in the 
Canadian Nurse, or add my name to the waiting list to receive them when available: 


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58 THE CANADIAN NURSE 


JANUARY 1967 



classified advertisements 


ALBERTA 


BRITISH COLUMBIA 


Regi.t.r.d Nur... (2-required immediately) far 20-bed, 
8 bassinet. active treatment hospital. Location. South- 
ern Alberta. Starting salary $370 with annual in- 
crement. to $420. recognition given for Qualifications 
and experience. 28 days vacation plus 9 statutory 
holidays. Board and room available in modern 
nurses' residence. Medical Insurance and Pension 
Plans available. Apply to: The Matron, or Adminis- 
trator, Bow Island General Hospital, Bow Island, 
Alberta. 1.11-2 


R.gist.r.d Nu.... for new 50-bed active treatment 
hospital situated only 15 miles from Edmonton. 
Salary $360 - $420 per month. Recognition given for 
previo\JI experience. Excellent personnel policies and 
working conditions. For further information please 
write to: Miss M. Macintosh, R.N., Director of 
Nursing, Fort Saskatchewan General Hospital, Box 
1270, Fort Saskatchewan, Alberta. 1.39-2 
Regi.t.r.d Nurse. WANTED (immediate vacancies) 
34-bed active treatment hospifar, fuliV accredited, 
located in prosperous farming district in central 
Alberta. Salary range $360 - $420 with experience 
recognized. AO hour week - 21 days annual vacation 
plus statutory holidays, with rotating 8 hour shifts. 
Full maintenance in nurses' residence $35 per month. 
For further information kindly contact: Mrs. M. Carter, 
Director of Nursing, Provost Municipal Hospital. Pro- 
vost, Alberta. t.73-1 
REGISTERED NURSES FOR GENERAL DUTY (WANTED) 
for a 37.bed General Hospital. Salary $380 - $440 
per month. Commencing with $375 with I year and 
$390 with 3 years practical experience elsewhere. 
Full maintenance available at $35 per month. Pen- 
sion plan available, train fare from any point in 
Canada will be refunded after t vear employment. 
Hospital located in a town of 1,100 population, 85 
miles from Capital City on a paved highway. 
Apply to: Two Hills Municipal Hospital, Two Hills, 
Alberta. t-88-1 


ADVERTISING 
RA TES 


FOR ALL 
CLASSIFIED ADVERTISING 


$10.00 for 6 lines or less 
$2.00 for each additional line 


Rates for display 
advertisements on reQuest 


Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 
The Canadian Nurses' Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses' Association of the 
Province in which they are interesteQ 
in working. 


Address correspondence to: 


The 
Canadian ð 
Nurse Ç7 


50 THE DRIVEWAY 
OTTAWA 4, ONTARIO 


JANUARY 1967 


I I 


ALBERTA 


NURSES FOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hat. 
Nurses on staff must be willing and able to take re- 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses' residence with all single rooms situated on 
ho.pital grounds. Apply to: Mrs. M. Hislop, Adminis- 
trator and Director of Nursing, Baslano General Hos- 
pital, BOlsano, Alberta. 1-5-1 


General Duty Nur.e. (2) for active treatment hospital 
15 beds; 2 Doctors, minimum monthly salary $355 
commensurate with experience. Extra pay for even- 
ings and nights. Fare refunded after 2 years satisfac- 
tory service. Apply giving experience and references 
to: Matron Administrator, Box 98, Bonnyville, Alberta. 
1-10.3 B 


General Duty Nurlel for an active accredited well 
equipped 64-bed hospital in a growing town, popu- 
lation 3,500. Centrally located between maior cities. 
Full maintenance available in a new residence, $35.00 
per month. Alberta Registered Nurses salary $360.00 
- $420.00, commensurate with experience. Excellent 
personnel policies and working conditions. Apply: 
Director of Nursing, Brooks General Hospital, Brooks, 
Alberta. 1-13-1 A 


GENeRAL DUTY NURSES - .alary range $4,140 to 
$4,980 per annum. 40 hour work week, modern liv- 
ing-in facilities available at moderate rates, if de- 
sired. Civil Service holiday, side. 'eave und pension 
benefits. Apply to: Baker Memorial Sanatorium, De- 
partment of Public Health, Calgary, Alberta. 1-14-3 


GENERAL DUTY NURSES for modern 25-bed hos- 
pital on Highway No. 12, East-Central Alberta. 
Salary range $380 to $440. (including a regional 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronation Municipal Hospital, 
Coronation, Alberta. Tel.: 578-3803. 1-25.IB 


GENERAL DUTY NURSES for 64-bed, active treatment 
haspital, 35 miles South of Calgary. Salary range 
$360 - $420. Living accommodation available in 
leparate residence if desired
 Full maintenance in 
residence $35 per month. 30 day. paid vacation after 
12 months employment. Please appl y to: The Director 
of Nursing, High River Municipa Hospital, High 
River, Alberta. 1-46-1 


GENERAL DUTY NURSES: Modern 26-bed hospital 
close to Edmonton. 3 buses daily. Salary $360.00 to 
$420.00 per month commensurate with experience. 
Residence available $35.00 per month. Excellent 
personnel policies. Apply: Director of Nursing, 
Mayerthorpe Municipal Haspital, Mayerthorpe, Al- 
berta. 1-61-1 


GENERAL DUTY NURSES for 94-bed General Hospital 
located in Alberta's unique Dinasaur Badlands. $360 
- $420 per month, 40 hour week, 3t days vacation, 
pension, Blue Cross, M.S.I. and generous sick time. 
Apply to: Miss M. Hawke., Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberta. 1-31-2 A 


General Duty Nurse for madern 50-bed active hos- 
pita' in Central Alberto, Highway No.2. Basic salary 
$360 - $420, 40 hour week, pension plans and group 
Blue Cross. Full maintenance $35 available. Apply 
to: Administrator, Ponoka General Hospital, Box 699, 
Ponoka, Alberta. 1-72-3 


GENERAL DUTY NURSES (6) and CERTIFIED NURS- 
ING AIDES for modern 72.bed hospital. Salary $355 
and $240 respectively; credit for experience; liberal 
palicies. Accommodation available. Apply to: Ad- 
ministrator, Providence Hospital, High Prairie, AI. 
berta. 1.45-1 


Operating Roam Nurse for new 30-bed hospital, 
active in surgery. Four doctors on medical staff. 
Salary Commensurate with training and experience. 
Hospital located 20 miles west of Edmonton. Apply 
to: Director of Nursing, Stony Plain Municipal Hos. 
pital, Stony Plain, Alberta. t-99-1 


BRITISH COLUMBIA 


Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Regi.t.red Nur.e. (ar tha.e eligible) to apply for 
positions in Medicine, Surgery and Psychiatry. Apply 
to: Director of Nursing. Victoria, British Columbia. 
2-76-4A 


I I 


Operating Raam Hood Nurse ($464 - $552), General 
Duty Nurs.. (B.C. Regist.red $405 - $481, non-Regis- 
tered $390) for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, curling 
and bowling. Hot springs swimming nearby. Nurses' 
residence, room $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36- 1 
B.C. R.N. far General Duty in 32 bed General Hospi- 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefits, modern, comfortable, nurses' residence in 
attractive community close to Vancouver, B.C. For 
application form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. I, Hope, B.e. 2-30- 1 
GENERAL DUTY NURSES (Twa) for active 66-bed 
hospital, with new hospital to open in 1968. 
Active In-service programme. Salary range $372 to 
$444 per month. Personnel policies according to 
current RNABC contract. Hospital situated in beauti- 
ful East Kootenays of British Columbia, with swim. 
ming, golfing and skiing facilities readily available. 
Apply to: The Director of Nursing, St. Eugene Hos- 
pital, Cranbraok, British Columbia. 2-15-1 
General Duty Nurses for well-equipped 80-bed Gener- 
al Hospital in beautiful inland Valley adiacent Lake 
V.athlyn and Hudson Bay Glacier. Initial salary $387. 
Maintenance $60, AO-hour 5 day week, vacation with 
pay, comfortable, attractive nurses' residence, 
Boating, fishing, swimming, golfing, curling, skating, 
skiing. Apply to: Director of Nursing, Bulkley Valley 
District Hospital, P.O. Box No. 370, Smithers, British 
Columbia. 2-67-1 
General Duty Nurse. (2 immediately) for active, 
26-bed hospitol in the heart of the Rocky Mountains, 
90 miles Irom Banff and Lake Louise. Accommoda- 
tion available in attractive nurses' residence. Apply 
giving full details of training, experience, etc. to: 
Administrator, Windermere District Hospital, Inver- 
mere, British Columbia. 2-31-1 
General Duty Nurses for new 30.bed hospital 
located in excellent recreational area. Salary and 
personnel pol icies in accardance with RNABe. Com. 
fortable Nurses' home. Apply: Director of Nursing, 
Boundary Hospital, Grand Fork., British Columbia. 
2-27-2 


General Duty Nurse. for active 30.bed hospital. 
RNABC policies and schedules in effect, also North- 
ern allowance. Accommodations available in res- 
idence. Apply: Director of Nursing, General Hospital, 
Fort Nelson, British Columbia. 2-23-1 
General Duty O. R. and experienced Obstetrical 
Nur.e. for modern, ISO-bed hospital located in the 
beautiful Fraser Valley. Personnel policies in ac. 
cordance with RNABe. Apply to: Director of Nursing, 
Chilliwack General Hospital, Chilliwack, British Co- 
lumbia. 2-13-1 
General DUlY, Operating Room and Experienced 
Ob.t.trical Nur.. for 434-bed hospital with school 
of nursing. Salary: $372-$444. Credit for past ex- 
perience and postgraduate training. AO-hr. wk. Stat. 
utory hol idays. Annual increments; cumulative sick 
leave; pension plan; 28-days annual vacation; B.C. 
registration required. .Apply: Director. of Nurs.ir:'9, 
Royal Columbian HOlpltal, New Westminster, Brltllh 
Calumbia. 2-73-13 
General Duty and Operating Roam Nurse. for 
modern 450-bed hospital with School of Nursing. 
RNABC palicies in effect. 1966 salaries from $372 
per month and up. Credit for past experience and 
pOSTgraduate training. British Columbia registration 
required. For particulars write to: the Director of 
Nursing Service, St. Joseph'. Hospital, Victoria, British 
Columbia. 2-76-5 
Graduate Nur.e. for 31-bed hospital on B.e. Coast. 
Salary $372 for B. C. Registered Nurses plus $15 
northern living allowance. Personnel policies in 
accordance with RNABe. Travel from Vancouver 
refunded after 6 mos. Apply: Administrator, General 
Hospital, Ocean Falls, British Columbia. 2-49.1 
GRADUATE NURSES for 24-bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel prac. 
tices in accord with RNABC. Accommodation availa- 
ble. Apply: Director of Nursing, General Hospital, 
Squamish, British Columbia. 2-68-1 
GRADUATE NURSES: Join us at the booming center 
af B.C.II Surrounded by 50 beautiful lakes with 
excellent boating, swimming, fishing plus all winter 
sports. On hour's drive from Prince George, the 
fastest growing city in Canada. Active 44-bed hos- 
pital and modern nurses' residence over looking the 
picturesque Nechako River. Starting salary $372 - $408, 
recognition given for experience. Health and pension 
plan, AD-hr. week and 4 weeks vacation. Write. to: 
Mrs. M. Grant, Director of Nursing, St. John Hospital, 
Vanderhoof, British Columbia. 2-74-1 
THE CANADIAN NURSE 59 



Registered Nurses for 21-bed hospitol in pleosont 
community - Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital, 
I Sheet Horbour, Nova Scotio. 6-32.1 
MANITOBA . 
Director of Nurses for up-to-date 38.bed hospital. I 
New nurses' residence of 1964 has separate nurses 
suite available. Sick leave, pension plan and other 
fringe ber.efit$ available. Personnel policies will be 
sent on request. Enquiries should include experience, 
qualifications and salary expected, and should be 
addressed to: Mr. O. Hamm, Administrator, Altona 
Hospital District No. 24, Box 660, Allono, Monit3_

i 


BRITISH COLUMBIA 


Graduate Nurses and Certified Nursing Alsistants 
for lO-bed acute General Hospital on Pacific Coast. 
Solary for Groduates in accordance with RNABC 
scale with credit for experience; B.C. Registered 
Procticols $260-$296. Board and room $25/m; 4-wk. 
vacation affer I-yr. Superannuation and medical 
plans. Apply: Director of Nursing, St. George's 
Hospital, Alert Bay, British Calumbia. 2-2-1 


Registered Nurses (2) for 50-bed General Hospitol in 
Fort Churchill, Monitoba. Starting salary $470 per 
,nonth with higher 1967 schedule effective January 1. 
Train fare from Winnipeg refunded after six months 
service, and return fare refunded after one year 
service. Apply to: Director of Nursing. For 
Churchill General Hospital, Fort Churchill, Mani- 
roba. 3-75-1 


Registered Nurses (:2) for 2J-bed modern hospital. 
Duties to Ccmmence as soon as possible. Salary min. 
$405 - $490 with fringe benefits. living-in aCCOm- 
modation available. A copy of our personnel policies 
will be mailed on request. Apply to: Mrs. C. James, 
Motron, Gilbert PI"ins District Hospital, Gilbert 
Plains, Manitoba. 3-25-2 


THE GlENBORO HOSPITAL has a position avoilable 
for one Registered Nurse, effective as soon as pos- 
sible. Glenboro Hospital is a 16-bed hospital 10- 
coted 100 miles west of Winnipeg on No. 2 High. 
way. Excellent residence accommodation available. 
Starting salary Jonuory 1st 1967 - $395 per month. 
Personnel Policy Manual and application forms on 
request with no obligation. Please forward all en- 
Quiries to: Mr. S_ A. Oleson, Box 130, Glenboro, 
Manitoba. Telephone No. 115 or No. 17 3-28-1 


Registered Nurse' for 18-bed hospital at Vita Monitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
ronge $380 - $440, with ollowance for experience_ 
40 hour wee:.:, 10 statutory holidays, 4 weeks paid 
vacation after one year. Full maintenance available 
for $50 per month. Apply: Matron, Vita District 
Hospital, Vita, Manitoba. 3-68-1 


Registered Nurses and Licensed Practical Nunes for 
232-bed Children's Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: D;rector of Nursing, Children's Hos- 
pital, Winnipeg 3, Monifoba. 3-72.1 


Registered Nurse for General Duty in 20-bed hospital. 
Solary ronge $380 - $440 per month to be increased 
Jan. I, 1967. Room and board avoiloble at $55.50 
per month. Generous personnel policies. Full details 
available on request. Apply: Director of Nursing, 
Reston Community Hospital, Reston, Man. 3.46-2 


Registered Nurses for General Duty for the newly 
built Swan River Hospital. Swan River is a progres- 
sive town with excellent shopping and recreational 
focilities. Sclary ronge $360 - $400 with excellent per- 
sonnel policies. For full details contact: Mrs. E. R. 
Boudin, Director of Nursing, Swan River Hospitol, 
Swan River, Manitoba. 3-62-2 


General Duty Nurses for 1 DO-bed active trea!ment hos- 
pital. Fully accredited. 50 miles from Winnipeg on 
Trons Canoda Highway. Apply: Director of Nursing 
Service, Portage District General Hospital, Portage La 
Proirie, Monitobo. 3.45.1 
Registered Nurses for General Duty in 18-bed hospitol. 
Daily bus service to larger centres. Starting salary 
$395 per month. All fringe benefits ond residence 
ovailable. Apply: Director of Nursing, Crystal City 
Memoriol Hospital, Crystal City, Monitoba. 3.16-1 


NEW BRUNSWICK 


ADMINISTRATOR for TobiQue Volley Hospital, PlaSler 
Rock New Brunswick. For further information apply: 
G. D: Gerrish, Secretary, Board of Management. 4-20-1 


NOVA SCOTIA 


SUPERINTENDENT for 16-bed hospitol, located in 
60 THE CANADIAN NURSE 


I I 


NOVA SCOTIA 


Cape Breton Highland National Park. This posi!ion 
will be availoble January 1, 1967. Accommodations 
available. APPLY: giving qualifications to Secretary, 
Buchanan Memorial Hospital, Neil's Harbour, Nova 
Scotia. 6-25-1 


ONTARIO 


Operoting Room Supervisor for 70-bed fully occredited 
hospital. Competitive salary, good personnel policies. 
For complete information apply to: Director of Nursing, 
Alexandra Hospital, Ingersoll, Ontario. 7-60-1 


Co
ordinator of Clinical Nursing Studies in the 
Bachelor of Science in Nursing Course: The School 
of Nursing, McMaster University, .i
vit!s ap:plic
ti.ons 
from persons with advanced qualifications In clinical 
nursing. The position is open for the 1967-1968 
session with duties commencing July 1967. Pleose 
apply 'sending curriculum vitae and two references 
to: Director, School of Nursing, McMaster University, 
Homilton, Ontorio. 7-55-15 


Registered Nurses for 34-bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462. 3-wk. vacotion with pay; sick leave after 
6-mo. se vice. All Stoff - 5 doy 40-hr. wk_, 9 
statutory holidays, pension plan and oth-:r 
enefits. 
Apply to: Superintendent, Englehort & D,stroct Hos- 
pital, Englehart, Ontario. 7.40-1 


Registered Nurses. Applications and enquiries are 
invited for general duty positions on the stoff of the 
Monitouwadge General Hospitol. Excellenr salary 
and fringe benefits. Liberal policies regardin
 ac- 
commodation and vacation. Modern well-eqUipped 
33-bed hospita( in new mining town, about 250-mÎ. 
eost of Port Arthur and north-west of White River, 
Ontario Pop. 3,500. Nurses' residence c
mprises .i
di. 
vidual self.contained opts. Apply, stating quallflca. 
tions, experience, age, marital status, pho
e numbe
, 
etc. to the Administrator, General Hospital, Mam- 
touwadge, Ontario. Phone 826-3251 7.74-1 A 


Registered Nurses: Applications are invited for Gener- 
01 Duty Staff Nurses; Gross salary ronge: $362 to 
$422. Supervisory advancement opportunities. Reside.nt 
accommodations available; Hospital situated in tOUrist 
town off Lake Huron. For further information write: 
Superintendent, Saugeen Memorial Hospital, South- 
ompton, Ontario. 7-122-1 


Registered Nurses for 35.bed active treatment h
spltal, 
35 m:les north east of Toronto, Ontario. Minimum 
salary $355 per month, and annual increments. Per- 
sonnel policies including, M.edical, O.H.S.C., weekly 
Indemnity Insurance, Ontario Hospital Pensi
n Plan, 
and Group life Insurance shared by th
 hOSPltol, plus 
other benefits. Apply to: The Superintendent, The 
Cottage Hospital (Uxbridge), Uxbridge, Ontario. 
7-135-1 


REGISTERED NURSES for 18-bed General Hospitol in 
Mining and Resort Town of 5,000 people. Beautifully 
located on Wawa Lake, 140 miles north of Sault Ste. 
Marie Ontario. Wide variety of Summer and Winter 
sports; swimming, boating, fishing, go
fing, skat.ing, 
curling and bowling. Six churches of different fOlths. 
Salory range $375 - $450 per month. Starting salary 
uP to $405; salary review at 3, 6, 12 mO'!ths frc:>>m 
date of hire and annually thereafter. D,fferent.o! 
pay for a'te:noon and night shifts. Bed and board 
available at reasonable rate. Excellent personnel 
policies. PI!!asant working conditions. Apply to: .The 
Administrator, The Lady Dunn General Hospital, 
Wawa, Ontario. 7-140-1A 


Registered Nur,es and Registered Nursing Assistants, 
for 100-bed General Hospital, situated in northern 
Ontario. Starting salary, Registered Nu.ses $390 per 
month. Registered Nursing Assistants $273 per month, 
shift differential, annual increment, 40 hour week, 
O. H. A. pension plan and group life insurance, 
O. H. S. C. and P. 5. I. pions in effect. Accommodo- 
tion available in residence if desired. For full por- 
ticulars apply: The Director of Nurses, lady Minto 
Hospital, Cochrc.ne, Ontario. 7-30-1 A 


Regiltered Nurses and Registered Nursing Assistants 
are invited to make applicat;on to oJr 75-bed, 
modern General Hospital. You will be in the Vaca 
tionland of the North, midway between the Lokeheod 
and Winnipeg, Mal"itoba. Basic salar.ies ore $371 
and $259 with yearly increments. WrIte or phone: 
The Dire
tor of Nursing, Dryden District General 
Hospital, DRYDEN, Ontario. 7-26-1 A 


REGiSTERED NURSES AND REGISTERED NURSING 
ASSISTANTS (IMMEDIATElY) for a new 40-bed hos. 


I I 


ONTARIO 


pital with nurses' residence. Nurses 
 minimum salary 
$387 plus experience allowance, 3 semi-annual incre
 
.-rents of $10 each. R.N.A:s - $270 plus experience 
ollowance, 2 annua[ increments of $10 each. Reply to: 
The Director of Nursing, Geraldton District Hospital, 
Geroldton, Ontario. 7-50-1 


Registered Nurses and Registered Nursing Assistants 
far 160-bed occredited hospital. Storting salary $387 
and $260 respectively with regular annual incre- 
ments for botn. Excellent personnel policies. Resid- 
ence accommodation available. Apply to: Director of 
Nursing, Kirkland & District Hospital, Kirklond lake, 
Ontario. 7-67-1 


Registered Nurses and Registered Nursing Assistants: 
Applications are invited from R. N's and R. N. Ass'ts. 
who are interested in returning to "nursing at the 
bedside" in 0 well-equipped General Hospitol. excel- 
lent starting salaries and fringe benefits now. Further 
increase January 1, 1967. Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux lookout General Hospital, P. O. Box 
909, Sioux lookout, Ontorio. 7-119-1 A 


Registered or Graduate Nurses, required for modern 
92-bed hospitol. Residence accommodation $20 month- 
ly. Overseas nurses ,^elcome. Lovely old Scottish 
Town near Ottowa. Apply: Director of Nursing, The 
Greot War Memorial Hospital, Perth, Ontario. 7-100-2 


Registered Nurses for General Duty in well-equipped 
28-bed hospital, locoted in growing gold mining 
ond tourist area, north of Kenora, Ontario. Modern 
residence with individual roomS; room, board and 
cniform laundry only $45. 40-hr. wk., no split shift, 
cLmulorive sick time, 8 statutory holidays and 28 
day paid vacation after one year. Starting salary 
5400. Apply to: Matron, Morgaret Cochenour Memo. 
rial Hospital, Cochenour, Ontario. 7.29-1 


Registered Nurses for General Duty and Operating 
Room, in modern 1 DO-bed hospital, situated 4D miles 
from Ottawa. Excellent personnel policies. Residence 
occommodation available. Apply to: Director of 
Nursing, Smiths Falls Public Hospital, Smiths falls, 
Ontorio_ 7-120-2A 


Registered Nurses for General Duty in 1000bed hos- 
pital, located 30-mi. from Ottawa, are urgently re. 
Quired. Good personnel policies, accommodation 
available in new staff residence. Apply: Director of 
Nursing, District Memorial Hospital, Winchester, On- 
torio_ 7-144-1 


Registered Nurses for General Duty and Operating 
Room in modern hospital (opened in 1956)_ Situated 
in the Nickel Capitol of the world, pop. 80,000 
people. Salary $372 per mo., with annual merit 
increments, ph..s anr'lual bonus pion, 4D-hr. wk. Recog- 
nition for experience. Good personnel policies. Assist- 
ance with transportation can be arranged. Apply: 
Director of Nursing, Memorial Hospital, Sudbury, 
Ontario. 7-127-4 


General Duty Nurses for 66-bed General Hospitol. 
5torting salary: $375/m. Excellent personnel policies. 
Pension plan, life insurance, etc., residence accom- 
modotion_ Only 10 min. !rom downtown _Buffolo. 
Apply: Director of Nursing, Douglas Memonal Hos- 
pital, Fort Erie, Ontario. 7-45-1 


Generol Duty Nurses for loo-bed modern hospitol. 
Southwestern Ontario, 32 mi. from London. Salary 
commensurate with experience and obility; $398/m 
basic salary. Pension plan. Apply giving full par
 
tlculors to: The Director of Nurses, D:strict Memorial 
Hosp,tol, Tillsonburg, Ontorio. 7-131-1 


General Duty Nurses, Certified Nursing Assistants & 
Operating Room Technician (I) for new 50-bed hos- 
pital with modern equipment, 40-hr. wk., 8 statutory 
holidays, excellent personnel policies & opportunity 
for advancement. Tourist town on Georgian Bay 
Good bus connections to Toronto. Apply to: Director 
of Nurses, General Hospitol, Meoford, Ontario. 7-79-1 


General Staff Nurses and Registered Nursing Assit.. 
tants are required for a modern, well-equipped General 
Hospitol currently exponding to 167 beds. Situoted in 
a progressive community in South Western Ontario, 30 
miles from Windsor-Detroit Border. Salary scaled to 
experience and Qualifications. Excellent employ.ee 
benefits and working conditions plus an opportumty 
to work in a Patient Centered Nursing Service. Write 
for further information to: Miss Patncia McGee, B. 
Sc.N., Reg.N. Director of Nursing, Lear:nington District 
Memorial Hospital, Leamington, Ontaflo. 7-69-1 A 


PUBLIC HEALTH NURSE (QUALIFIED) For generalized 
Public Health programme. Present salary under revi- 
sion. Direct enquiries to: Miss Beatrice Whalley, Super- 
visor of Public Health Nursing, Waterloo Country 
Heolth Unit, 109 Argle Street, South. PRESTON, ON- 
TARIO 10.109-2 
JANUARY 1967 



EL CAMINO HOSPITAL 


Registered Nurses - 
All Services 
Sfarting salary for 
Experienced 
Regisfered Nurses 
$550 per month 
448-bed fully-occred- 
ited general hospi- 
tal located 40 min- 
ufes south of 
downfown Son 
Francisco 
Ample opportunify 
for professional 
development as 
there are two col- 
leges and two uni- 
versities in the 
immediate vicinity 
Excellent recreafional 
facilifies in close 
proximify to The 
hospifal 


. 


LOCATED IN BEAUTIFUL SANTA CLARA VALLEY 
YEAR 'ROUND SMOG-FREE TEMPERATE CLIMATE 


- 


- 
., 


... 


'f'" 


Benefits Include: 


Plonned orientation 
program 
Continuing in-service 
educafion 
Two fo four weeks 
vacation 


Eighf paid holidays 
Accumulative sick 
leave 
Free group life 
insurance 



. 


Fully paid health in- 
surance including 
family coverage 
Fully paid refirement 
program 
liberal shift 
differential 
40-hour week 


.. 


; w _ 


, ".... 


-.. 



 


..... .1. -" 



 


DIRECTOR 
OF NURSES 


Applications are invited for this 
position in a 44-bed active Gen- 
eral Hospital. Position carries a 
good deal of responsibility in- 
cluding nursing personnel, phar- 
macy, new projects planning. 
New projects are two new hos- 
pitals with centralized services 
and exciting concepts for mod- 
ern patient care. Located in Cen- 
tral British Columbia, one hour 
west of Prince George in an area 
of noted development, this dis- 
trict abounds with lakes and 
forests, good summer and winter 
sports. Excellent salary and staff 
benefits depending on qualifi- 
cations and experience. 


Apply to: 
Administrator 


ST. JOHN HOSPITAL 


Vanderhoof, 
British Columbia 


JANUARY 1967 


''to 


, . 


....... 


t " ' 



...\ 


Apply to: 
PERSON N EL DI RECTOR 
EI Camino Hospital 
2500 Grant Road 
Mountain View r California 94040 


ASSISTANT DIRECTOR 
OF NURSING 


Applicafions are invifed for the position 
of Assisfont Director of Nursing in on 
occredited, modern, 244-bed ocufe-care 
hospital. locafed in the rapidly growing, 
scenic interior of Brifish Columbia, this 
hospital is undergoing progressive ex- 
pansion. 


Nursing adminisfrative education and ex- 
perience desirable. Salary commensurafe 
with qualifications. 


Suite availoble in stoff residence. 


Apply stating qualifications and 
expected salary to: 
Director of Nursing 


PRINCE GEORGE REGIONAL 
HOSPITAL 


Prince George, British Columbia 


OPERATING ROOM 
SUPERVISOR 


With Postgraduate Course in 
Operating Room technique 
and management 


Required for a 375-bed fully 
accredited General Hospital with 
projected reconstruction program. 
Salary based on qualifications 
and experience. 


Fringe benefits include hospital 
and medical coverage, generous 
sick leave, three weeks' vacation 
and contributory pension plan. 


For further information write: 


Director of Nursing Service 
METROPOLITAN 
GENERAL HOSPITAL 


Windsor, Ontario 


THE CANADIAN NURSE 61 



r 


ONTARIO 


OPERATING ROOM NURSES (2) for 0 fully oc. 
credited 70-bed Generol Hospital. For Operating 
Room Duty. Salary according to experience. Apply to: 
O.R. Supervisor. Penefanguishene General Hospital, 
Penetanguishene, Ontario. 7-99-2 


Public Health Nurses for generalized program. Every 
modern fringe beneiit. Full credit for experience. 
Present solary ronge $5,030 - $6,148. Further, we 
are prepared to give consideration to any salary 
request. Apply to, E. G. Brown, M.D., D.P.H. Director 
ond M.O.H., Kent County Health Unit, 21 - 7th. St., 
Chothom, Ontorio. 7-24-4 


PUBLIC HEALTH NURSES (2 QUALIFIED) - Staff 
positions available in the City of Oshawa. Duties to 
commence January 3rd. 1967. General ized program 
in an official agency. Solary $5,658 to $6,507. 
Beginning salary according to experience. Liberal 
personnel policies and fringe benefits. Apply to: Mr. 
D. Murray, Personnel Officer, City Hall, 50 Centre 
Street, Oshawa, Ontario. 7-92-2 


Public Health Nunes for generalized programme in 
o County-City Health Unit. Salary schedule as of 
January I, 1967, $5,100 to $6,100. 20 days vacation. 
Employer shared pension pion, P.S.1. and hospital- 
ization. Mileage allowance or unit cars. Apply to: 
Miss Veronica O'Leary, Supervisor of Public Health 
Nursing, Peterborough County-City Health Unit, P.O. 
Box 246, Peterborough, Ontario. 7-101-4A 


PUBLIC HEALTH NURSES for generalized public health 
program. Good personnel policies including 4 weeks' 
vacotion, sick time allowance, unit car or car allow- 
ance, shared pension plan, hospitalization, and 
group insurance available. Apply to: Mrs. Muriel 
McAvoy, Secretary-Treasurer, Porcupine Health Unit, 
70 Balsam Street South, Timmins, Ontario. 7-132-2 


QUEBEC 


RESIDENT CHilDREN CAMPS IN THE lAURENTIANS, 
REQUIRE: Graduate Nur.e. for the summer. Apply: 
JEWISH COMMUNITY CAMPS, 6655 Cote des Neiges 
Rood, Suite 260, Montreal 26, Quebec. Phone 
735-3669. 9-47-63A 


SASKATCHEWAN 


DIRECTOR OF NURSING for modern 24-bed active 
treatment hospital. Graduates in nursing administration 
or with experience will be given preference. Accommo- 
dation available in nurses' residence. Salary schedule 
will be based on the SRNA recommondations. Apply: 
Mr. R. Holinaty, Administrator, Wakaw Union Hospital, 
Wokaw, Soskatchewon. 10-131-1 A 


MATRON for 10.bed hospital at Willow Bunch in 
South Centro I Soskatchewan. Population 600; bus 
service, modern utilities, recreational facilities, friend- 
ly folks. $450 per month; 40 hour week. Room in 
nurses' residence and board in hospital supplied at 
low cost. Call or write: R. Granger, Sec.- Treas., 
Willow Bunch Union Hospital, WilLOW BUNCH, 
Soskatchewan. - PHONE: 473-2450 (Area Code 306). 
10.138-1 


Regist.red Nu.... wanted for 12-bed hospital. Solaries 
and benefits as per SRNA schedule. Residence accom- 
modation on hospital grounds. Daily bus service to 
cities. Apply fa: The Matron, Mr.. M. Gile., Caronach 
Union Hospital, Coronach, Saskatchewan. 10-18-1 


REGISTERED NURSE for 9-bed haspital. Duties to 
commence as soon as possible. Salary accarding to 
SRNA schedule with allowance for experience. Room 
and board for $34.50 per month. Apply to: Secre- 
tary, Hodgeville Union Hospital, Hodgeville, Sos- 
kotchewan. 10.45.1 


REGISTERED NURSES far 24-bed active treotmenT hos- 
pital. Established personnel policies and pension plan. 
Solary range as per SRNA recommendatians. Adjust- 
ments to starting salary made for previous experience. 
Residence accommodation available at $43.50 per 
month. Apply: Mrs. Z. Johnson, Acting Director of 
Nursing, Wakaw Union Hospital, Wakaw, Saskatche- 
wan. 10-131-1 


Registered Nurse and Certified Nursing Alliltont for 
45-bed General Hospital in progressive north central 
Soskatchewan community. Daily bus service to two 
maior cities. SRNA policies and salaries in effect 
plus added fringe benefits, ie. group life insurance. 
pension plan, accumulative sick leave to 120 days. 
Board and lingle rooms available in residence at 
$43.50 per month. Apply ta: Mrs. C. Fisher, R.N., 
Acting Director af Nursing, Wadena Union Hospital, 
Wadena, Sask. 10-130-1 


62 THE CANADIAN NURSE 


I I 


SASKATCHEWAN 


Regi.t.r.d Nur... far G.neral Duty (2) in fully 
modern 27-bed ho.pital. Initial salory $364 per month. 
Personnel policies according to Sask. Reg. Nurses' As- 
sociation recammendations. New modern residence, 
excellent working conditions. Duties to commence 
when convenient. Apply to: Superintendent of Nursing 
Services. Kipling Memorial Union Hospital, Kipling, 
Soskatchewon. 10-59-1 


General Duty and Operating Room Nurses, also 
Certified Nursing Assistants for 560-bed University 
Hospital. Salary commensurate w.th experience and 
preparations. Excellent personnel pol icies. Excellent 
opportunities to engage in progressive nursing. Ap- 
ply: Director of Personnel, University Hospital, Sas- 
kotoon, Saskotchewan. 1O.1t6-4A 


UNITED STATES 


Regist.r.d Nurs.. wanred for 78-bed General Hos- 
pital. Staning salaries at $525 per month with 
regular increments and shift differential. Good per. 
sonnel policies. Social activities include skiing and 
boating. Must be eligible for Alaska registration. 
Apply to: The Director of Nursing Service, St. Ann's 
Hospital, 419 - 6th Street, Juneau, Alaska 99801. 
15-2-3 


REGISTERED NURSES - Southern Californio - Op. 
portunities available - 368-bed modern hospital in 
Medical-Surgical, Labor and Delivery, Nursey, Oper- 
ating Room and Intensive and Coronary Care Units. 
Good salary and liberal fringe benefits. Continuing 
inservice education program. Located 10 miles from 
Los Angeles near skiing, swimming, cultural and edu- 
catianal facilities. Temporary living accommodations. 
Apply: Director of Nursing Service, Saint Joseph 
Hospital, Burbank, California 91503. 15.5-63 
REGISTERED NURSES needed for rapidly expanding 
general hospital on the beautiful Peninsula near 
San Francisco. Outstanding policies and benefits, 
including temporary accommodatians at law cost, 
health coverage, fully refundable retirement plan, 
liberal shift differentials, no rotation, exceptional 
in-service and orientation programs, unl imited sick 
leave accrual, unlimited vacation accrual, sick leave 
conversion to vacation, tuition reimbursement. Ex
 
cellent salaries based on experience. Cantact Person- 
nel Administrator, Peninsula Hospital, 1783 EI 
Camina Real, Burlingame, California - 697-4061. 
15-5-20 B 


Registered Nurses, Career satisfaction, interest and 
professional growth unlimited in modern, JCAH ac- 
credited 243-bed hospital. Locoted in one of Califor- 
nia's finest areas, recreational, educational and cul- 
tural advantages are yours as well as wonderful 
year-round climate. If this combination is what 
you're looking for, contact us nowlStaff nurse en- 
trance salary abave $500 per month; increases to 
$663 per month; supervisory positions at highest 
rotes. Special area and shift differentials to $50 per 
month poid. Excellent benefits include free heolth 
and life Insurance retirement, credit union and liberal 
personnel policies. Profenional staff appointments 
available in all clinical areas to those eligible for 
California licensure. Write today: Director of Nursing. 
Eden Hospital. 20103 lake Chabot Road, Costro Val- 
ley, Californio. 15-5-12 
REGISTERED NURSES Opportunities available at 
415-bed hospital in Medical-Surgical, labor and 
Delivery, Intensive Care, Operating Room and Psy- 
chiatry. No rotation of shift, good salary, evening 
and night differentials, liberal fringe benefits. 
Temporary living accommodations available. Apply: 
Miss Dolores Merrell, R.N., Personnel Director, Queen 
of Angels Hospital, 2301 Bellevue Aevnue, los 
Angeles 26, Cal ifornia. 15-5-3G 
REGtSTERED NURSES - Come to smog-free Orange 
in California. Near beaches and mountains; 35 miles 
from los Angeles. New, modern 290-bed St. Joseph 
Hospital and adjoining 50-bed Childrens Hospitol of 
Orange County. Need staff nurses all .hifts in 
surgical, medical, pediatrics, intensive care unit, 
cardiac care unit, neuropsychiatric unit, operating 
room, emergency room, and recovery room. Excellent 
salary and benefits. Write to: Persannel Director, 
St. Joseph Hospital, Orange, California, for personnel 
policy handbook and details regarding salaries, etc. 
15.5-56 
REGISTERED NURSES - SAN FRANCISCO Children's 
Hospital ond Adult Medical Center hospifal for men. 
women and children. California registration required. 
Opportunities in all clinical areaS. Excellent salaries. 
differentials for evenings and nights. Holidays, vaca- 
tions, sick leave, life insurance, health insurance and 
employer
paid pension-plan. Applications and details 
furnished on reQuest. Contact Personnel Director, Chil. 
dren's Hospital, 3700 California Street, San Francisco 
18, Californio. 15.5-4 


REGISTERED NURSES - Generol Duty for 84-bed 
JCAH hospital 1 J12 hours from Son Francisco, 2 
hours from lake Tohoe. Starting salary $510/m. 


I I 


UNITED STATES 


with differentials. Apply: Director of Nur.es, Mem- 
orial Hospital, Woodland, California. 15-5-49B 


R.gi.tered Nur.e. for 303-bed modern hospital. Po- 
sitions available - All services, na shift rotatian. 
liberal benefits, advancement apportunities, educa. 
tional opportunities in area, equal opportunity 
employer. Apply: Director of Nursing Service, Kaiser 
Foundation Hospitals, San Francisco 15, California. 
Phone (JO 7-4400) 15-5.57 


REGISTERED NURSES: Mount Zion Hospital and Me. 
dical Center's increased salary scales now double our 
attraction for nurses wha find they can afford to live 
by the Golden Gate. Expansion has created vacancies 
for staff and specialty assignments. Address enquiry 
to: Personnel Department, 1600 Divisadera Street, San 
Francisco, California 94115, An equal opportunity em- 
ployer. 15-5-4 C 


Registered Nurses - California. Expanding, accredit- 
ed 303-bed hospital in medical center af Southern 
California. University city. Mountain - ocean resort 
area. Ideal year-round climate, smog free. Starting 
salary $6,300. With experience, $6,600. Fringe bene- 
fits, shift differential, initial housing allowance. 
Wide variety rentals available. For details on Cali- 
fornia license and Visa, write: Director of Nursing, 
COllage Hospitol, 320 W. Pueblo Street, Santo Bar- 
bara, Californio 93105. 15.5-39 A 


REGISTERED NURSES GENERAL DUTY - SURGERY. 
Will assist with immigration. Come to California and 
live in beautiful Sacramento which is within a 
short drive of the Sierra summer and winter recrea. 
tional areas. Two large modern hospitals offer an 
excellent variety af nursing experiences. P.M. Staff 
$555, P.M. Surgery $595. Write: Personnel Depart- 
ment, Sutter Hospitals, 2820 "L" Street, Sacramento, 
California. 15-5.43B 


NURSE TEAM LEADER POSITIONS in new 372-bed, 
fully accredited, General Hospital in resort areo. $461 
per month days and $485 per month evening and 
nighT shift. liberal fringe benefits. For descriptive bro- 
chure and policies write: l. Sims, North Miami Gene. 
ral Hospital, 1701 NE 127th Street, North Miami, 
Florido. 15-10-2 A 


REGISTERED NURSES: ExcellenT opportunity for ad- 
vancement in atmosphere of medical excellence. Pro- 
gressive patient care including Intensive Care and 
Cardiac Care Units. Finely equipped growing 200. 
bed suburban community hospital iust on Chicago's 
beautiful North Shore. Completely air conditioned 
furnished apartments, paid vacation, after six months, 
staff development progrom, and liberal fringe bene- 
fits. Starting salary from $466. Differential of $30 
for nights or evenings. Contact: Donold L Thamp- 
son, R. N., Director of Nursing, Highland Park Hos- 
pital, Highland Park, Illinois 60035. 15.14-3 A 


Registered Nurses and Certified Nursing Assistants. 
Opening in several areas, all shifts. Every other week- 
end aff, in small community hospital 2 miles from 
Boston. Rooms available. Hospital paid life insurance 
and other I iberol fringe benefits. RN salary $ lOOper 
week, plus differentiol of $20 for 3-11 p.m. and 
11-7 a.m. shifts. C.N. Ass'ts. $76 weekly plus $10 for 
3-11 p.m. and 11-7 o.m. shifts. Write: Mi.s Byrne, 
Director of Nurses, Chelsea Memmorial Hospital, 
Chelsea, Massachusetts 02150. 15.22-1 C 


NURSES, Register.d, for modern 36O-bed hospital. 
Openings available in all areas, medicine-surgery, 
delivery room, nursery, and postpartum. Near Wayne 
State University, and on integral part of the new 
Medical Center. Salary $550 ta $635 per manth 
plus differential for afternoon and night. Premium 
pay for weekends. Good fringe benefit. including 
Blue Cross ond Life Insurance. Apply: Personnel 
Director, Hutzel Hospital formerly Womon's Hospital), 
432 East Hancock, Detroit, Michigan 48201. 15-23-1 F 


STAFF NURSES: Needed to staff present fully occredit- 
ed hospitol and new facility to open December 1967. 
All services ond shifts available. Good salaries and 
fringe benefits. Will pay transportation to and from. 
Minimum one year contract. For particulars concerning 
hospital ond community write: L E. Thompson, Ad- 
ministrator, or V. Jenkins, Director of Nursing, Scioto 
Memoriol Hospifal, Portsmouth, Ohia. 15-36-4 


ALBERTA 


General Duty Nurses and Cer1ified Nursing Aide. for 
modern combined active treatment and Auxiliary 
Hospital. Solary start. ot $355 ond $240 respectively. 
Liberal personnel policie!., accommodation available. 
located in Southern Alberto close to U. S. boundory 
and Waterton-Glacier International Peace Park. The 
61-bed combined hospital serves the town and area of 
approximately 6,000 population with aU services,. 
Apply to: The Director of Nursing, Cardston Municipol 
Hospital, Box 310, Cardston, Alberta. 1-17-1 


JANUARY 1967 



THE HOSPITAL 


FOR 


SICK CHILDREN 


" 


1\0- 


, 
, 



 
,J 
1 


I 


I' 


YOU 


Receive the advantages of: 


1. Five-week orientation 
gram for new staff. 


pro- 


2. Ongoing in-service education 
for nurses. 


3. Extensive student education 
program. 


4. Research Institute. 


APPLICATION FOR GENERAL 
DUTY POSITIONS INVITED 


For information contact: 


THE DIRECTOR OF NURSING 


555 University Avenue 
Toronto, Canada 


IANUARY 1967 


UNITED STATES 


I I 


UNITED STATES 


REGISTERED NURSES FOR STAFF AND CHARGE. Posi- 
tjons in an expanding, full V accredited General 
Hospital. Intensive Care, Medical, Surgical, Obste- 
trical areas, and In-service Education program. Lo- 
cation: Central to beaches, mountains, Stote Uni- 
versity. Good salary, regular increments. Opportunity 
for advancement. Apply: Director, Nursing Service, 
Beverly Hospitol, 309 W. Beverly Blvd_, Montebello, 
California. 15-5-59A 


REGISTERED NURSES - Positions ovailoble for Charge 
Nurses in beautifully equipped new convalescent hos- 
pital, specializing in post surgical core. Work every 
other weekend. COr]tact the Personnel Director, Berkley 
Convalescent Hospital, 1623 Arizona Avenue, Santa 
Monico, California 90404. t5-5-40 B 
REGISTERED NURSES: for 75-bed air conditioned 
hospital, growing community. Storting salory $330- 
$365/m, fringe benefits, vacation, sick leave, holi- 
days, life insurance, hospitalization. 1 meal furnish- 
ed. Write: Administrator, Hendry General Hospital, 
Clewiston, Florida. 15-10-1 


Staff Duty positions (Nurses) in private 403-bed 
hospital. liberal personnel policies and salary. Sub- 
stantial differential for evening and night duty. 
Write: Personnel Director, Hospital of The Good 
Samaritan, 1212 Shatto Street, los Angeles 17. 
California. 15-5-311 


General Duty Nurses - Present hospital 55-beds 
with new 75-bed hospital to ooen April, I, 1965. 
located on lake Okeechobee near west Palm Beach. 
liberal personnel policies, 40-hr. wk., bonus at end 
of first year. Minimum starting salary $380, with 
differential for evenings and nights. Apply: Director 
of Nursing Service, Glades General Hospital, P.O. 
Box 928. Belle Glade, Florida. 15.10-3 


Nurses for new 75.bed General Hospital. Resort 
area. Ideal climate. On beautiful Pacific ocean. 
Apply to: Director of Nurses, South Coast Com- 
munity Hospital, South laguna, California. 15-5-50 


. 


REGISTERED 


. . 


NURSES 


. 


. 


. 


THE 


350-BED 


SARNIA GENERAL 


H 


s 


A 


L 


p 


T 


C) 


ASKS 


- 


What Are You Seeking? 


WE OFFER 


the opportunity 
1. to work directly with patients 
2. to participate in group decisions 
3. l.O.A. with financial assistance to further your 
in nursing 


education 


If you are interested . contact the Personnel Director, Sarnia General 
Hospital r Sarnia, Ontario 


THE CANADIAN NURSE 63 



OSHA W A 
GENERAL HOSPITAL 


GENERAL DUTY NURSES FOR 
ALL DEPARTMENTS 


Starting salary for Ontario Regis- 
tered nurses $400 with 5 annual 
increments to $480 per month. 
Credit for acceptable previous 
service - one increase for two 
years, two increases for four or 
more years. 
Non-registered - $360.00 
Rotating periods of duty - 3 
weeks vacation - 8 statutory 
holidays. 
One day's sick credit per month 
beginning in the 7th month of 
service cumulative to 45 days. 
Pension Plan and Group Life 
Insurance - Hospital pays 50% 
of Medical, Blue Cross and Hos- 
pital Insurance premiums. 
Apply to: 
Director of Nursing 
OSHAWA GENERAL HOSPITAL 
Oshawa, Ontario 


ST. JOSEPH'S 
HOSPIT AL 
HAMIL TON. 
ONTARIO 


A modern, progressive hospital, 
located in the centre of Ontario's 
Golden Horseshoe- 
invites applications for 
GENERAL STAFF 
NURSES 


and 


REGISTERED 
NURSING ASSISTANTS 


Immediate openings are avail- 
able in Operating Room, Psy- 
chiatry, Intensive Care - Coro- 
nary Monitor Unit, Obstetrics, 
Medical, Surgical and Paediatrics. 
For further information write to: 
THE DIRECTOR OF NURSING 
ST. JOSEPH'S HOSPITAL 


Hamilton, Ontario 


(,4 THE CANADIAN NURSE 


REGISTERED NURSES 
for General Duty 


North Shore of Lake Athabaska 


Modern 30-bed General Hospital, 
located in young active mining 
community. 
Salary: $414 - $529. 
Attractive nurses' residence a- 
vailable. Room and board at $45 
monthly. Superior employee ben- 
efits. - Air transportation paid 
from Edmonton or Prince Albert. 


Please send enquiries to the . 


Director of Nursing 


MUNICIPAL HOSPITAL 


Uranium City, 
Saskatchewan. 


DIRECTOR 
OF NURSING 


Applications are invited for the 
position of Director of Nursing. 
This is a unique hospital offering 
rehabilitation and chronic care to 
48 handicapped children who 
present many challenges. Ex- 
pansion plans are being studied 
to provide rehabilitation for 18 
to 21 year old adolescents. Pre- 
ference will be given to a director 
with preparation and experience 
in nursing administration and 
particular interest in rehabilita- 
tion. 


Please address 01/ enquiries to: 


The Administrator 
BLOORVIEW CHILDRENS HOSPITAL 
278 Bloor Street East 
Toronto 5, Ontario 


ASSISTANT DIRECTOR 
OF NURSING 


Applications are invited for the 
above position in a fully ac- 
credited 163-bed General Hos- 
pital in beautiful Northern On- 
tario. 


Desirable qualifications should 
include B.S.N. Degree with ex- 
perience in supervision. 


For further information, 
Write to: 


Director of Nursing 


KIRKLAND and DISTRICT HOSPITAL 


Kirkland Lake, Ontario. 


ONTARIO SOCIETY 
FOR 
CRIPPLED CHILDREN 
requires 
· Camp Directors 
· General Staff Nurses 
· Registered Nursing Assistants 
for 
FIVE SUMMER CAMPS 
located near 
OTTAWA COLLINGWOOD 
LONDON - PORT COLBORNE 
KIRKLAND LAKE 


Applicafions are invifed from nurses in- 
teresfed in fhe rehabilitafion of physically 
handicapped children. Preference given to 
CAMP DIRECTOR applicanfs having super- 
visory experience and to NURSING ap- 
plicants with paediafric experience. 


Apply in writing to: 
Miss HELEN WALLACE, Reg. N., 
Supervisor of Camps, 
350 Rumsey Road, 
Toronto 17, Ontario 


JANUARY 196; 



CANADA'S INDIANS 
NEED YOUR 


AND ESKIMOS 
HELP 


PUBLIC HEALTH NURSES 
REGISTERED HOSPITAL NURSES 
CERTIFIED NURSING ASSISTANTS 


HAVE YOU CONSIDERED 
A CAREER 
WITH 
MEDICAL SERVICES 
DEPARTMENT OF NATIONAL HEALTH AND WELFARE 


lor 'urther inlormation. write to: 
MEDICAL SERVICES DIRECTORATE 
DEPARTMENT OF NATIONAL HEALTH AND WELFARE 
OTTAWA. CANADA 


DIRECTOR OF NURSING 


- 
- 


........" 
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...-. "111.1" 
- .......ill 
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"'1". 
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',.. . I 
1"....1, 


, ' 


Applications are invited 
for the 


tIP' 
- 



.. 


POSITION OF DIRECTOR OF NURSING 


.. 


The Director of Nursing will be responsible for 
the administration of all nursing services within 
the hospital. The hospital currently operates 
375 beds and is undergoing extensive moderni- 
zation and expansion costing $3,750,000. There 
is a furnished apartment available at a mini- 
mum rental. A 140 student School of Nursing 
housed in a modern residence and operated 
by the hospital is the responsibility of a Director 
of Nursing Education. 


Address enquiries to: 


THE SCARBOROUGH 
GENERAL HOSPITAL 


Invites applications from General Duty Nurses. 
Excellent personnel policies. An active and stimulat- 
ing In-Service Education and Orientation Programme. 
A modern Management Training Programme to as- 
sist the career-minded nurse to assume managerial 
positions. Salary is commensurate with experience 
and ability. We encourage you to take advantage 
of the opportunities offered in this new and expand- 
ing hospital. 


Fort William. Ontario 


McKELLAR GENERAL HOSPITAL 


For further information write to: 
Director of Nursing 
SCARBOROUGH GENERAL HOSPITAL 
Scarborough, Ontario 


DOUGLAS M. McNABB. Administrator 


JANUARY 1967 


THE CANADIAN NURSE 65 




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YORK COUNTY HOSPITAL 


NEWMARKET, ONTARIO 


HOSPITAL: 
A newly expanded 257 bed hospital wifh such progressive 
pofient core concepts os 0 12-bed J.e.u., 22-bed psychiofric 
ond 24-bed self core un if. 
IDEAL LOCATION: 
45 minutes from downtown Toronfo, 15-30 minutes from 
excellent summer and winfer resort areas. 
SALARIES: 
Registered Nurses: $372-$447 per month. 
Registered Nursing Assistonfs: $277-$310 per monfh. 
BENEFITS INCLUDE: 
Furnished oporfmenfs, medico I ond hospifOI insuronce, group 
life insuronce, pension plan, 40 hour week. 


Please address 01/ enquiries to: 
Director of Nursing 
YORK COUNTY HOSPITAL 
596 Davis Drive 
Newmarket, Ontario 


TEACHERS OF NURSING 


By August, 1967 the Royal Victoria Regional School 
of Nursing requires three teachers in medical-surgical 
nursing, two in Operating Room techniques and one 
in psychiatric nursing. 
Teachers qualified with a baccalaureate degree or a 
diploma in nursing education will assist in classroom 
teaching and accompany the students to one of the 
six regional hospitals for clinical experience. 
This is a new programme in an independent school. 
The faculty are eager to develop the best possible 
curriculum. A new building for classrooms will be 
erected in 1967. 
Barrie is fifty miles north of Toronto and noted for its 
summer and winter spon facilities. 
Solaries are at the Toronto level with increments paid 
to experienced teachers. Personnel policies and job 
descriptions will be sent on request. 


Please write to: 


The Director, 


ROYAL VICTORIA REGIONAL SCHOOL OF NURSING 


61 Wellington Street West, Barrie, Ontario. 


66 THE CANADIAN NURSE 


MAIMONIDES HOSPITAL 
AND HOME FOR THE AGED 


AN OPPORTUNITy.... 
A CHALLENGE.... 
A NEW EXPERIENCE.... 


SUPERVISORS, STAFF NURSES, NURSING 
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC 
NURSE: 


We invite you to join the nursing staH of New Mai. 
monides. 


LIBERAL VACATION " HEALTH AND 
PENSION PLANS . . SALARIES COM. 
MENSURA TE WITH RECOGNIZED SCALES 


Apply to: 


DIRECTOR OF NURSING 


5795 Caldwell Avenue 
Montreal 29, Quebec 


THE ST. CA THARINES 
GENERAL HOSPITAL 


A modern SOO-bed hospital located in the heart 
of the beautiful Niagara Peninsula, within 
easy travel distance from Buffalo, Hamilton 
and Toronto, invites applications from: Gener- 
al Staff Nurses. 


Pleasant working conditions. Excellent per- 
sonnel policies. 


Apply: 


The Director of Nursing Service 
THE ST. CATHARINES 
GENERAL HOSPITAL 
St. Catharines, Ontario 


JANUARY 1967 



What does 
Methodist Hospital 
have to offer me? 


At the Methodist Hospital, where research is a part 
of progress, a nursing career takes on new horizons - 
rich in meaning and professional satisfaction. 
If you're looking for the chance to be the nurse 
you've always dreamed of - coming to the world 
famous Methodist Hospital can be an adventure - 
almost like stepping into the future - splendid 
facilities, so much advance equipment and 
everywhere the newest medical and patient care 
techniques are in use. 
Some of the best aspects of nursing at METHODIST 
are as old as medicine itself - there is a spirit of 
kindness and consideration, and emphasis on patient 
care, that make this a hospital where nursing is 
satisfying and rewarding, day by day. 
Methodist Hospital is right in the center of the world's 
great Medical, Research and Educational complexes. 
HOUSTON is an exciting city - rodeo and opera, 
pro-football and the famous Alley Theatre, water sports 
and beaches an hour or less away, the Houston 
Symphony and the Astrodome! 


A Few Quick Facts: We're affiliated with Baylor 
University College of Medicine and associated with 
Texas Woman's University College of Nursing. 
New $9>'2 million Cardiovascular and Orthopedic 
Research Center will open soon. Our Inservice 
EducatIon Department gives you thorough 
orientation, and continued instruction in new 
concepts and techniques. You'lIlind every 
encouragement to broaden your Skills, 
including tuition assistance in obtaining 
further education in nursing. 


.. 


Send for Your Colorful Informative Illustrated 
Brochure. . . to learn about Methodist Hospital, 
Houston, positions available, salary and employment 
benefits, tuition allowance, complimentary room 
accommodation and our Nurse Specialist Programs. 
Write, call or send coupon, Director of Personnel, 
The Methodist Hospital, Texas Medical Center, 
Houston, Texas 77025 


....j 


r-------------------------------------ì 
I Director of Personnel, THE METHODIST HOSPITAL, Texas Medical Center, Houston, Texas 77025 I 
I Please send me your brochure about nursing opportunities at "(HE METHODIST HOSPITAL-Texas Medical Center I 
I I 
I Name I \. 
I Address I 
I I 
I City State Zip Code I 
L_____________________________________ 


DIRECTOR OF SCHOOL 
OF NURSING 


REQUIRED FOR 
DISTRICT SCHOOL OF NURSING 


The 
Canadian 
Nurse 


1965 INDEX 


Minimum Requirement - B. Sc. N., with five years 
experience, two of these in Nursing Education. 


Apply to: 


Mr. Harold Swanson, Chairman, 


BOARD OF NURSING EDUCATION 


220 Clarke Street 


WOODSTOCK, ONTARIO 


An index of materials appearing 
in Volume 61 of 


THE CANADIAN NURSE 


is now available. 


Write for your copy to 


Miss PIERRETTE HOTTE 
at National Office, 
50 The Driveway, 
Ottawa 4 


THE CANADIAN NURSE 67 


JANUARY 1967 



ADDITIONAL CLINICAL TEACHERS 


required 


to assist in Developing New Curriculum and a 
Regional School. 
School of Nursing Building is New 
and well equiped. 
Salaries and Fringe Benefits at Metropolitan level. 
Qualifications - B.Sc.N. 
or 
Diploma in Nursing Education. 


GENERAL STAFF NURSES 


Required for all Services 
Salaries and Fringe Benefits at Metropolitan level. 


Apply to: 
DIRECTOR OF NURSING 
BRANTFORD GENERAL HOSPITAL 


Brantford, Ontario 


MANITOBA ASSOCIATION 
OF REGISTERED NURSES 


Invites applications lor the positions 01 


REGISTRAR 


Applicants are required to hold a baccalaureate degree in nursing 
wifh experience in odministrafion, and in inferpersonal relafions. 
Duties include providing for registrafion and membership in the 
M.A.R.N. and fhe mainfenance of the official register of member 
of the Association. 
Salary to be Negofiafed. 


and 


PERSONNEL OFFICER 


The applicant musf have the following qualifications: 
Baccalaureafe Degree desirable. Masfer's Degree preferred. 
Experience in administration and in working with individuals and 
organizations desired. 
Duties include promotion of the economic and social welfare of 
nurses. 
Salary to be Negotiated. 


All Inquiries shoutd be Addressed to: 
Mrs. Helen P. Glass, President, 
MANITOBA ASSOCIATION Of REGISTERED NURSES, 
247 Balmoral Street, 
Winnipeg 1, Manitoba, 


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STAFF NURSE POSITIONS 
Salary Range $482-$620 


with maximum starfing $539 on day shift. 
$592 evening and/or night shifts. Credit 
given for education and/or experience. 
Opportunity to gain knowledge and skill 
in a specialized cancer research hospital. 
Registration in Texos required. Excellenf 
personnel benefits include: 3 weeks vaca- 
tion, holidoys, cumulative sick leave, 
laundry of uniforms furnished, refirement 
ond Social Securify programs, Hospitaliza- 
tion, life and Disabilify Income Insurance 
available. Equal opportunity employer. 


UNIVERSITY 
OF ALBERTA 
HOSPIT AL 


Positions are available in our 
rapidly expanding Medical Cen- 
tre situated on a growing Uni- 
versity campus. All service in- 
cluding renal dialysis, coronary 
intensive care and cardiac surg- 
ery offer opportunities for ad- 
vancement. 


For applicafion and additional information 
Write to: 


Personnel Manager 


THE UNIVERSITY Of TEXAS 
M.D. ANDERSON HOSPITAL AND 
TUMOR INSTITUTE 


Apply to: 
Director of Nursing 
UNIVERSITY Of ALBERTA 
HOSPITAL 
Edmonton, Alberta 


Texas Medical Center 
Houston, Texas 77025 


68 THE CANADIAN NURSE 


RIVERSIDE 
HOSPIT AL 
OF OTTAWA 


A new, air-conditioned 340-bed 
hospital. Applications are called 
for Nurses for the positions of: 


HEAD NURSE - Operating Room 
ASSISTANT HEAD NURSES 
GENERAL STAFF NURSES 
and 
REGISTERED NURSING ASSISTANTS 


Address all enquiries to: 
Director of Nursing 
RIVERSIDE HOSPITAL OF OTTAWA 
1967 Riverside Drive, 
Ottawa, Ontario 


JANUARY 1967 



PALO ALTO-STANFORD 
HOSPITAL CENTER 


located on the beautiful campus of Stanford University in Palo Alto, California. 


" 


.. 
11 


. 
-- 


- ----- 


"We invite you to join our professional staff and to gam unparalled experiences in 
nursing." 


For additional information- 
NAME: 
ADDRESS: 
CITY: 
SERVICE DESIRED: 
Return to: PALO ALTO-STANFORD HOSPITAL CENTER 
Personnel Department 
300 Pasteur Drive 
Palo Alto, California 


STATE: 


REGISTE RED NURSES 
REGISTERED NURSING 
ASSIST ANTS 


REQUIRED FOR 


ST. MARY'S HOSPITAL 
TIMMINS, ONTARIO 
MODERN - 200 BED HOSPITAL 
EXCELLENT PERSONNEl POLICIES 
PLEASANT TOWN OF 30,000 
WIDE VARIETY OF SUMMER 
AND WINTER SPORTS - 
SWIMMING, BOATING, 
FISHING, GOLFING, SKATING, 
CURLING, TOBOGGANING, 
SKIING AND ICE FISHING. 


Apply to: 
Director of Nursing Service 
ST. MARY'S HOSPITAL 


Timmins, Ontario 


IANUARY 1967 


VICTORIA HOSPIT At 


LONDON, ONTARIO 


Modern 1,000-bed hospital 
Requires 
Registered Nurses for 
all services 
and 
Registered 
Nursing Assistants 


40 hour week - Pension plan 
- Good salaries and Personnel 
Policies. 


Apply: 


Director of Nursing 


VICTORIA HOSPIT At 


London, Onto 


ST. JOSEPH'S HOSPITAL 


TORONTO, ONTARIO 


REGISTERED NURSES 
and 
REGISTERED 
NURSING ASSISTANTS 


700-bed fully accredifed hospital provides 
experience in Operating Room, Recovery 
Room, Intensive Care Unit, Pediatrics 
Orthopedics, Obstetrics, General Surgery 
and Medicine. 
Orientation and Acfive Inservice program 
for all staff. 
Salary is commensurafe wifh preparafion 
and experience. 
Benefits include Canada Pension Plan, 
Hospital Pension Plan, Group Life I nsu- 
ranee. Sick leave - 12 days after one 
year, Ontario Hospifal Insuranæ - 50% 
payment by hospital. 
Rofafing Periods of duty - 40 hour week, 
8 sfatutory holidays - annual vacation 
3 weeks offer one year. 


Apply: 


Assistant Director of 
Nursing Service 


ST. JOSEPH'S HOSPITAL 


30 The Queensway 
Toronto 3, Ontario 


THE CANADIAN NURSE 69 



THE HOSPITAL 


FOR 


SICK CHILDREN 


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OFFERS: 


1. Satisfying experience 


2. Stimulating and friendly en- 
vironment. 


3. Orientation and In-Service 
Education Program. 


4. Sound Personnel Policies 


5. liberal vacation. 


APPLICA TrONS FOR REGISTERED 
NURSING ASSISTANTS INVITED. 


For detailed information 
please write to: 


The Assistant Director 
of Nursing 
AUXILIARY STAFF 


555 University Avenue 
Toronto, Ontario, Canada 


70 THE CANADIAN NURSE 


HUMBER MEMORIAL HOSPITAL 


HOSPIT AL - 
Newly expanded 350-bed hospital. Progressive patient care con- 
cept. 


SALARY - 
General Staff Nurses (Currently Registered in Ontario) $400.00 - 
$480. - 5-increments. 
Registered Nursing Assistants (Currently Registered in Ontario) 
$295.00 - $331.00, - 3 increments. 
HOUSING - 
Furnished apartments available at subsidized rates. 


JOB SATISFACTION - 
High quality patient care and friendly working environment. We 
appreciate our personnel and encourage their professional develop- 
ment. 


You are invited to enquire concerning employment opportunities to: 
Director of Nursing 


HUMBER MEMORIAL HOSPITAL 


200 Church Street, Weston, Ontario 
Telephone 249-8111 (Toronto) 


CALGARY GENERAL HOSPITAL 


requires immediately 


REGISTERED GENERAL DUTY NURSES 


This is a modern 1,OOO-bed hospital including a new 
200-bed convalescent-rehabilitation section. Benefits 
include Pension Plan, sick leave, and shift differen- 
tial plus a liberal vacation policy and salary range 
$360 - $420 per month commensurate with training 
and experience. 


Apply to: 


Director of Nursing Service 


CALGARY GENERAL HOSPITAL 


Calgary, Alberta 


JANUARY 1967 



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specialization 


401 


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education 


.... 



 


recreation 


SpecIalize at either the 424 bed Grace Central 
HospItal in the new $250 million Detroit Medical 
Center or at the 448 bed Grace Northwest Hospital. 
(Grace is second largest in terms of admissions in 
MIchigan.) 
Further your education at nearby Wayne State 
University or one ot the many smaller colleges 
nearby. 
Enjoy your leisure time in the heart of the 
cultural and entertainment center of dynamic 
DetroIt or enJoy the all-year around sports and 
recreatIon of Michigan. 
Staft nurses at Grace earn from $500 to $600 
per month for days and $514 to $629 for evening 
and night duty plus very generous fnnge benefits. 
Other pOSItions pay even more. For full informa- 
tion contact" Director of Nursing. 


GRACE CENTRAL HOSPITAL 
4160 John R. Street. 
DetroIt. MichIgan 48201 
or 
GRACE NORTHWEST HOSPITAL 
18700 Meyers Road. 
DetroIt. MichIgan 48235 


IANUARY 1967 


ASSISTANT 
ADMINISTRATOR 
(NURSING) 


" 
t 


To assume full responsibility 
for the nursing service functions 
of a 1,000 bed teaching hospital, 
located in a modern medical 
centre, and to coordinate nursing 
educafion activities with the ser- 
vice functions. 


Post Graduate qualifications in 
nursing, hospital management, 
or business administration; and 
administrative experience rela- 
ted to the responsibilities of this 
position, are required. 


The salary level will recognize 
the responsibilities of the position 
and the qualifications of the ap- 
plicant. 


Director of Nursing 
Service 


Required to assist in the ad- 
ministration of the Department 
of Nursing in directing and 
supervising patienf care. 


Post Graduate Nursing quali- 
fications and experience in 
nursing administration or super- 
vision, are desired. 


Attractive salary and benefits. 


Please direct applications to: 


Dr. L. O. BRADLEY, 
Executive Director, 


WINNIPEG GENERAL 
HOSPITAL 


700 William Avenue, 
Winnipeg, Manitoba 


Phone Area #204--774-6511 
Collect 


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If you're ready for a change, but 
reluctant to make the move, we 
have an added incentive-a free 
airline ticket. Of course, it isn't 
really free-you'll have to take a 
position in a modern, progressive, 
expanding hospital and you'll 
have to live in a mild, sunny met- 
ropolitan area, rich in educational 
and cultural opportunities. But 
that isn't too much to ask, is it? 


f?:h 


PRESBYTERIAN HOSPITAL CENTER 
ALBUQUERQUE, NEW MEXICO 811 06 
UStarting salary to $555 a month 
u500-bed hospital 
o Personal orientation program 
uLiberal fringe benefits 
UContinuing educational programs 
=*Career advancement opportunities 
uTwo universities 
UTwenty minutes from nearby 
mountain ski area 
EQUAL OPPORTUNITV EMPLOVER 


Mail coupon or call collect (505-243-9411, Elt. 219) 


Mrs. Susan Dicke. Director of Nurse Recruitment 
Presbyterian Hospital Center. Oepartment B 
Albuquerque, New Mexico 87106 


Please mall me more information about nursing 
at Presbyterian Hospital Center and tell me how 
I may fly there at your expense. 


Name 


Address 


City 


State 


School of Nursing 


Ve.r of Graduation _Month 
.-.-.-....-- ...-....... - ..-...-.- 


THE CANADIAN NURSE 71 



SCHOOL OF NURSING 
WOODSTOCK GENERAL HOSPITAL 


Requires the following Faculty 
a) Psychiatric Teacher (One). 
b) Medical and Surgical Teachers (Two). 
Minimum requirement - B. Sc. N_ 
The above oddifionol staff is required 
for New Program. 


Apply to: 
Director of Nursing Education 
WOODSTOCK GENERAL 
HOSPITAL 
Woodstock, Ontario 


SOUTH PEEL HOSPITAL 


COOKSVtllE, ONTARIO 


A new 450-bed General Hospital, located 
12 miles from the City of Toronto. hos 
openings for: 


(1) GENERAL STAFF NURSES in all d.. 
partments; 


(2) Regiltered Nursing Assistants in all 
departments. 


For information or application, write to: 


Director of Nursing 
SOUTH PEEL HOSPITAL 
Cooksville r Ontario 


KINGSTON GENERAL HOSPITAL 


KINGSTON, ONTARIO 
Inferesting chonges in our physical planf 
ore taking ploce at Kingston Generol 
Hospifal. We invife you to join OUr 
Nursing Staff and share in providing 
qualify care fo our patienfs. We offer 
you a basic orientation and an ongoing 
educafion programme. Sfarting salary is 
dependent on Ontario registration, pre- 
parafion and experience. Kingsfon is the 
home of Queen's Universify and the 
Royal Milifary College and is ideally 
located in the Thousand Islands area. 
as well as close to the Metropolitan 
areas of Monfreal. Toronfo and New 
York City. 
Apply to: 
MISS S. M. BURKINSHAW r 
Dirf'ctor of Nursing, 


72 THE CANADIAN NURSE 


OPERAT1NG ROOM 
SUPERVISOR 


Postgraduate trained. 
For 61-bed well-equipped 
hospital. 


Apply: 
Administrator 


WILLETT HOSPITAL 


Paris, Ontario 


PUBLIC HEALTH NURSES 


required for 
HEALTH BRANCH 
B. C. Civil Service 
Positions available for qualified Public 
Healfh Nurses in various centres in Brifish 
Columbia. 
SALARY: $432 - $530 per monfh; car 
provided. An opportunity for interesting 
and challenging professional service in this 
beautiful ond fost-developing Province. 
For further information and application 
forms, apply to: 
The Director, Public Health Nursing, 
Deparfment of Health Service. and 
Hospitat Insurance, Parliament Building.. 
VICTORIA, B. C., or to The Chairman, 
B. C. CIVil SERVICE COMMISSION, 
544 Michigan Street, 
VICTORIA, B. C. 
COMPETITtON No. 66:281 A 


PETERBOROUGH CIVIC HOSPITAL 


School of Nursing requires 


INSTRUCTRESS (Nursing Arts) 
INSTRUCTRESS (Medical.Surgical Area) 
New self-contained education building for 
school of nursing now open. 
Trent Universify is sifuated in Peterborough 


For further information write to: 


Director of Nursing 
PETERBOROUGH CIVIC 
HOSPITAL 
Peterborough, Ontario 


SCHOOL OF NURSING 
PUBLIC GENERAL HOSPITAL 


Chatham, Ontario 
requires 


INSTRuaORS 


Student Body of 130 
Modern self-confained education building 
Universify Preparation required with 
salary differential for Degree. 


For further information, 
apply to: 
Director, Nursing Education 


GRADUATE NURSES 


Eligible for regisfrafion in the 
Province of Ontario. 


Various positions available as SUPER. 
VISORS. HEAD NURSES. and GENERAL 
DUTY NURSES. Excellent opportunities for 
advancemenf in all areos of modern. 
newly expanded 1,OOO-bed General Hos- 
pital, including O.R. and Recovery, Inten- 
sive Care. Emergency, Central Supply. 
Medical and Surgical Units. 


Please contact: 
Director of Nursing 
HENDERSON GENERAL 
HOSPIT AL 
Hamilton, Ontario 


REGISTERED GENERAL 
DUTY NURSn 


For 75-bed active hospital located 70 
miles Easf of Saskatoon. 


Excellent personnel policies. 


Apply: 
Director of Nursing Service 
ST. ELIZABETH'S HOSPITAL 
Humboldt, Saskatchewan 


JANUARY 1967 



nurses 


who want to 
nurse 


At York Central you can join 
an active, interested group of 
nurses who want the chance to 
nurse in its broadest sense. Our 
I 26-bed. fully accredited hospi- 
tal is young. and already talking 
expansion. Nursing is a profes- 
sion we respect and we were the 
first to plan and develop a unique 
nursing audit system; new mem- 
bers of our nursing staff do not 
necessarily start at the base salary 
of $372 per month but get added 
pay for previous years of work. 
There are opportunities for gain- 
ing wide experience, for getting 
to know patients as well as staff. 


Situated in Richmond Hill, all 
the cultural and entertainment fa- 
cilities of Metropolitan Toronto 
are available a few miles to the 
South. .. and the winter and 
summer holiday and week-end 
pleasures of Ontario are easily 
accessible to the North. If you 
are realIy interested in nursing, 
you are needed and will be made 
welcome. 


Apply in person or by mail to the 
Director of Nursing. 


YORK 
CENTRAL 
HOSPITAL 


RICHMOND HILL, 
ONTARIO 
NEW STAFF RESIDENCE 


!ANUARY 1967 


Registered Nurses 


AND 


Registered 
Nursing Assistants 


For 300-bed Accredited General 
Hospital situated in the pictur- 
esque Grand River Valley. 60 
miles from Toronto. 


Modern well-equipped hospital 
providing quality nursing care. 
Excellent personnel policies. 


For further information write: 
Director of Nursing Service 
SOUTH WATERLOO 
MEMORIAL HOSPITAL 
Galt, Ontario 


REGISTERED NURSES 


250-bed General Hospital, ex- 
panding to 400, located in San 
Francisco, California. Positions on 
all shifts for nurses in Intensive 
Care Unit, Operating Room, and 
General Staff Duty. Salary range 
effective April 1967, $600-$700. 
Health and life Insurance, Retire- 
ment Program - all hospital 
paid. liberal holiday and vaca- 
tion benefits. Accredited medical 
residencies in Medicine, General 
Surgery, Neuro Surgery, Ortho- 
pedics, and Plastic Surgery. 


For further information write to: 


Miss Lois Jann, 
Director of Nursing 


FRANKLIN HOSPITAL 


14th and Noe Streets, 
San Francisco, California 


THE 
NORTHWESTERN 
GENERAL 
HOSPITAL 


[- 
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. 


THE HOSPITAL- 
Fu lIy accredited 
Progressive 250 bed hospital 
Planned expansion to 400 beds 
20 minutes to downtown Toronto. 


YOUR PROFESSIONAL GROWTH 
Planned orientation programme 
Continuing inservice education. 


BENEFITS INCLUDE- 
3 weeks vacation 
8 statutory holidays 
Cumulative sick leave 
Group life insurance 
Hospitalization 
40 hour week. 


HOUSING - 
Furnished apartments at reduced rates. 


For information contact: 
Director of Nursing 


NORTHWESTERN 
GENERAL HOSPI' AL 
2175 Keele St., 
Toronto 15, Onto 


THE CANADIAN NURSE 73 



WOODSTOCK GENERAL HOSPITAL 


Requires 


GENERAL STAFF NURSES 


ALL DEPARTMENTS 


and 


O.R. TECHNICIANS 


Apply: 
Director of Nursing 
WOODSTOCK 
GENERAL HOSPITAL 
Woodstock, Ontario 


McKELLAR GENERAL HOSPITAL 


requires 
Registered Nurses for general Staff. The 
hospital is friendly and progressive. 
It is now in the beginning stoges of a 
$3,500,000 program of expansion and 
renovation. 


- Openings in all services. 
- Proximity to lakeheod 
ensures opportunity for 
educafian. 


University 
furthering 


For full particulars write to: 
Acting Director 
of Nursing Service 
McKELLAR GENERAL HOSPITAL, 
Fort William, Ontario. 


ST. JOSEPH'S HOSPITAL 
SCHOOL OF NURSING 
Hamilton, Ontario 


requires 


CLINICAL INSTRUCTORS in all Nursing 
areas. Well-equipped. modern School of 
Nursing. Student enrolment over ]00. 
Modern. progressive. BOO-bed Hospital. 
Salary commensurate with preparation 
and experience. 


For further details, apply: 


DIRECTOR OF NURSING 


74 THE CANADIAN NURSE 


PORT COLBORNE 
GENERAL HOSPITAL 
!'ORT COLBORNE, ONTARIO 


ST AFF NURSES 


required 


For 166-bed hospital within easy driving 
disfance of American and Canadian me- 
tropolifan centres. Considerafion given for 
previous experience obtained in Canada. 
Completely furnished apartment-style resi- 
dence, including balcony and swimming 
pool facing lake, adjacenf to hospital. 


Apply: 
Director of Nursing 
GENERAL HOSPITAL 
!'ort Colborne,Ontario 


REGISTERED NURSES 


For new 100-bed General Hospital in 
resorf town of 14,000 people, beaufifully 
located on shores of lake of fhe Woods. 
Three hours' travel time from Winnipeg 
with good transparfation available. Wide 
variety of summer and winter sports- 
swimming. boofing, fishing, golfing, skaf- 
ing. curling, fobogganing, skiing and ice 
fishing. 
Salary: $372 for nurses registered in 
Ontario with allawanæ for experience. 
Residence available. Good personnel poli. 
cies. 


Apply to: 
DIRECTOR OF NURSING 
KENORA GENERAL HOSPITAL 


Kenora, Ontario 


OTTAWA CIV1C HOSPITAL 


OTTAWA, ONTARIO 


This modern 10B7-bed teaching hospital 
requires: 


REGISTERED NURSES 
FOR All SERVICES INQUDING 
OPERATING ROOM AND PSYCHIATRY 


Excellent salaries. personnel policies and 
fringe benefits are available. 


Apply in writing to: 


B. JEAN MILLIGAN, Reg. N., M.A. 
Assistant Director 


ST. JOSEPH'S HOSPITAL 


LONDON. ONTARIO 


Teaching Hospital, 600 beds, new focilifies 


requires: 


REGISTERED NURSES 
REGISTERED NURSING ASSISTANTS 


For further information apply: 


The Director of Nursing 
ST. JOSEPH'S HOSPITAL 
London, Ontario 


DIRECTOR OF NURSING 
EDUCATION 


Masfer's degree preferred; fo conduct 
basic nursing program and offilliate pro- 
gram. 


Apply to: 
Director of Nursing, 
CHILDREN'S HOSPITAL 
OF WINNIPEG, 
Winnipeg, Manitoba. 


ST. THOMAS-ELGIN 
GENERAL HOSPITAL 


Requires 
GENERAL STAFF NURSES 
REGISTERED NURSING 
ASSIST ANTS 
O. R. TECHNICIANS 


Modern 395 bed, fully accredifed General 
Hospital opened in 1954, with School 01 
Nursing. Excellent personnel policies. 
O. H. A. Pension Plan. Pleasant progres- 
sive industriol city of 22,500. 


Apply: 
Director of Nursing, 
ST. THOMAS-ELGIN GENERAL 
HOSPIT Al 
St. Thomas, Ontario. 


JANUARY 1967 



SUNNYBROOK 
HOSPIT AL 


REGISTERED NURSES 


General Duty Nurses on rotating 
shifts are needed as port of the 
re-organization of Sunnybrook as 
a university teaching hospital. 
Employment in our Nursing Ser- 
vices Department includes: 


Metro Toronto Salary Scale 
Accommodation at reduced 
rates. Full range of fringe 
benefits 


Three weeks vacation after 
1 year 


Good location 
subway on 
grounds. 


bus from 
to hospital 


For additional information, 
please write: 
Director of Personnel 
and Public Relations, 


SUNNYBROOK HOSPITAL 


2075 Bayview Avenue 
Toronto 12, Ontario 


ANUARY 1967 


POSITIONS ARE AVAILABLE 


for 


REGISTERED NURSES 


with special interest in medical 
nursing and rehabilitation of 
long term patients. 
Salaries recommended by the 
Registered Nurses' 
Association of Ontario 
Inservice educational program- 
me developed and 
expanding 
Residence accommodation avail- 
able at a very mod- 
erate rate 
Transportation advanced, if re- 
quested 


Apply to: 
Director of Nursing 


THE QUEEN ELIZABETH HOSPITAL 
130 Dunn Avenue 
Toronto 3, Onto 


REGISTERED NURSES 


for General Duty 


In modern 20-bed hospital locat- 
ed in thriving northwestern On- 
tario community. Starting salary 
$335 minimum to $400 maxi- 
mum for three years' experience. 
Board and room in modern 
nurses' residence is supplied at 
no charge. Excellent employee 
benefits and recreational facili- 
ties available. Further particulars 
on request. Apply giving full 
details of experience, age, avail- 
ability, etc. to: 


Employment Supervisor 


MARATHON CORPORATION 
OF CANADA LIMITED 


Marathon, Ontario 


ONTARIO SOCIETY 


FOR 


CRIPPLED CHILDREN 


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Invites applications from Public 
Health Nurses who have at least 
2 years experience in general- 
ized public health nursing, pre- 
ferably in Ontario. 


INTERESTING AND VARIED 
PROFESSIONAL SERVICES 
IN AN EXPANDING PROGRAM 
INCLUDE: 


. an opportunity to work direct- 
ly with children, their parents, 
health and welfare agencies, 
and professional groups 


. participation in arranging 
diagnostic and consultant cli- 
nics 


. assessing the needs of the 
individually handicapped chjld 
in relation to services provided 
by Easter Seal Clubs and the 
Society. 


Attractive salary schedule with 
excellent benefits. Car provided. 
Pre-service preparation with sa- 
lary. 


Apply in writing to: 


Director, Nursing Service, 
350 Rumsey Road, 
Toronto 17, Ontario 


THE CANADIAN NURSE 75 



REGISTERED NURSES 


Staff posifions available in acute and 
convalescent unit of large General Hospital 
located in San Francisco Bay Area. Sfarfing 
salary $550 fo $605 plus differenfial. Ex. 
cellent benefits. 


Apply: 
SEQUOIA HOSPITAL 
Whipple and Alameda 
Redwood City, California 


222 BED GENERAL HOSPITAL 


requires 


STAFF NURSES 
REGISTERED NURSING ASSISTANTS 


Cornwall is noted for its summer and 
winter sporf areas, and is an hour and a 
half from both Montreal and Ottawa. 
Progressive personnel policies include 4 
weeks vacafion. Experience and posf.basic 
cerfificafes are recognized. 


Apply to: 
Ass't. Director of Nursing 
(service) 
CORNWALL GENERAL HOSPITAL 
Cornwall, Ontario 


EVENING OR NIGHT 
SUPERVISOR 


For 70lbed active hospital located 70 
miles East of Saskafoon. Salary com- 
mensurate wifh experience and qualifica- 
tions. Excellent personnel policies. 


Apply: 
Direclor of Nursing Service 
ST. ELIZABETH'S HOSPITAL 
Humboldt, Saskatchewan 


76 THE CANADIAN NURSE 


REGISTERED NURSES 


required for 
82-bed hospifal. Sifuafed in the Niagara 
Peninsula. Transportafion assistance. 


For salary rafes and personnel policies, 


apply to: 
Director of Nursing 
HALDIMAND WAR MEMORIAL 
HOSPITAL 


Dunnville, Ontario 


DIRECTOR OF NURSING 


Applicafions are invited for the above 
position in a modern, 56.bed, fully ac- 
credited hospital wifh expansion plans 
under active study. Nursing administrafive 
educafion and experience desirable. 
Salary commensurate with qualifications. 


Apply: 
Mrs. M. Fearn, Executive Director 
THE BARRIE MEMORIAL 
HOSPITAL 
Ormstown" Quebec 


CLINICAL INSTRUCTOR 
FOR OPERATING ROOM 


required by 


ROYAL COLUMBIAN HOSPITAL 


School of Nursing, 
New Westminster, B.C. 


For further information contact 


Director of Nursing 


THE UNIVERSITY OF 
WESTERN ONTARIO 
SCHOOL OF NURSING 


annOunces 
FACULTY POSITIONS 
available for the following programmes: 
I. A Four-Year Basic Degree ProgrammE 
(B.Sc.N.) beginning in September 1966 
2. Degree Programme for Graduafe Reg. 
istered Nurses. 
3. Exponding graduate programmes 
(M.Sc.N.). 
Enquires are invifed from qualified person! 
who are interesfed in Universify teaching 
opporfunifies in the School of Nursing of a 
rapidly developing Health Sciences Centre. 
For information write to: 
The Dean, School of Nursing 
THE UNIVERSITY OF 
WESTERN ONTARIO 
London, Canada 


REGISTERED NURSES 


Positions available in several hospitals 
in Easf Cenfral Saskafchewan ranging 
from 10 - 75 beds. Saskafchewan Reg- 
isfered Nurses' Associafion so lory schedule 
and personnel policies in effect. 


For further information apply to: 
Executive Director 
EAST CENTRAL REGIONAL 
HOSPITAL COUNCIL 
Suite 4, Smith Block, 
Yorkton, Saskatchewan 


GENERAL DUTY NURSES 
and 
NURSING ASSISTANTS 


Wanfed for acfive General Hospital (125 
beds) sifuated in St. Anfhony, Newfound- 
land, a town of 2,400 and headquarfers 
of the International Grenfell Association 
which provides medical care for northern 
Newfoundland and the coo sf of labrador. 
Salaries in accordance with ARNN. 


For further information 
please write: 
Miss Dorothy A. Plant 
INTERNATIONAL GRENFELL ASSOCIATION 
Room 701A, 88 Metcalfe Street. 
OTTAWA 4. ONTARIO 


JANUARY 1967 



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GUY'S HOSPITAL 
LONDON 
TO REGISTERED NURSES Of 
ACCREDITED SCHOOLS Of NURSING 


If you are visiting Great Britain. why not widen your professional 
experience and consider joining the staff at Guy's Hospital? 
Appointmenfs for six months are offered in all Branches of general 
nursing, in the specialised unifs. and privafe pafienfs wing. 
The furnished accommodation is excellent and all modern facilities 
are available. The Hospital is ideally situated for exploring London. 
Those nurses who are inferested and would like further information, 
please write to: 
The Matron, Cuy's Hospital, 
London, S. E. 1. 


giving details of your nursing training. and subsequent experience. 


SCHOOL OF NURSING 
BROCKVILLE 
GENERAL HOSPITAL 


Requires 


TEACHERS 


For the recently approved two year curriculum with 
a third year of experience in nursing service. You 
will enjoy participating in the development of a 
progressive school which emphasizes planned learn- 
ing experiences for the students. Theory is taught 
concurrent with clinical experience. 
Qualifications: Bachelor of Science in Nursing 
or Diploma in Nursing Education 
or Diploma in Public Health Nursing 
Excellent salaries and personnel policies. 
You would enjoy living in the attractive "City of 
the Thousand Islands" two and one half hours from 
Expo 67. 


For further information contact: 
The Director, School of Nursing 
BROCKVILLE GENERAL HOSPITAL 
Brockville, Ontario 


IANUARY 1967 


THE MONTREAL GENERAL HOSPITAL 


offers a 
6 month Advanced Course in 
Operating Room Technique and 
Management to 
REGISTERED NURSES 


with a year's Graduate experience 
in an Operating Room. 
Classes commence in September and 
March for selected classes of 
8 students 


For further information apply to : 
The Director of Nursing 


THE MONTREAL GENERAL HOSPITAL 


Montreal 25, Quebec 


THE CANADIAN NURSE 77 



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REGISTERED & GRADUATE 
NURSES 


Are required to fill vacancies in a modern, centrally 
located Hospital. Tours of duty are 7:30 - 4:00, 3:30- 
12:00 and 11 :30 - 8:00. 
Salary range for Registered Nurses is $382.50 to 
$447.50 per month and for Graduate Nurses is 
$352.50 to $417.50 per month. We offer a full 
range of employee benefits and excellent working 
conditions. 
Day Care facilities for pre-school children from 3 
months to 5 years in age. 


Apply in person, or by letter to : 
Personnel Manager, 
THE RIVERDALE HOSPITAL 
St. Matthews Road, 
Toronto 8, Ontario. 


DALHOUSIE UNIVERSITY 
offers 
NEW DIPLOMA PROGRAM 


in 


OUTPOST NURSING 


A program extending over two calendar 
years has been developed to prepare 
graduate nurses for service in remOfe 
areas of Northern Canada. Major areas 
within fhe cOurse of sfudy will include: 
Public health nursing 
Complete midwifery 
Basic clinical medicine 
Insfrucfion will be highly individualized. 
!sf year - To be spenf affhe University. 
2nd year - To consist of an internship 
direcfed by fhe Universify in 
selected northern agencies. 
Candidates should have complefed at 
least one year of professional nursing. 
Upon complefion of fhe program students 
will receive a Diploma in Public Health 
Nursing and a Diploma in Outpast 
Nursing. 


For further information write to: 
Director, 
SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY 
Halifax, Nova Scotia 


78 THE CANADIAN NURSE 


REGISTERED NURSES 


Lutheran General Hospital, Park Ridge, Illinois is a 
new 587-bed General Hospital, located in a pleasant 
suburb of Chicago. 
The hospital is modern with a wide range of services 
to patients, including Hyperbaric Oxygen Unit. Low- 
cost modern housing next to the hospital is available. 
The hospital is completely air-conditioned. 
Annual beginning salary is from $6,000 plus shift 
differential pay. Regular salary increments at six 
months of service and yearly thereafter. Sick leave 
and other fringe benefits are also available. 


Write or call collect: 


Director of Nursing Services 


LUTHERAN GENERAL HOSPITAL 
PARK RIDGE, ILLINOIS 60068 
Telephone: 692-2210 Ext. 211 
Area Code: 312 


THE WINNIPEG 
GENERAL HOSPITAL 


Offers the following opporfunify for ad- 
vanced preparation to qualified Regisfered 
Graduate Nurses: 


A SIX MONTH CLINICAL COURSE 
in 
OPERATING ROOM 
PRINCIPLES AND ADVANCED 
PRACTICE 


The caurse commences in September of 
each year. Mointenance is provided, and 
a reasonable sfipend is given each month. 
Enrolment is limifed to a maximum of 
fen sfudenfs. 


For further information please 
write to: 


THE DIREOOR OF NURSING 
700 William Ave. 
Winnipeg 3 


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DALHOUSIE 
UNIVERSITY 


Degree Course in Bosic Nursing - (B.N.) 
4 years 
A progrom eXfending over four calendar 
years leading to the Bachelor of Nursing 
degree is offered to candidates with a 
Nova Scotia Grade XII sfanding (or equiv- 
alenf) and prepares the student for nursing 
practice in hospitals and fhe communify. 
The curriculum includes studies in the 
humanities. nursing and fhe sciences. 


Degree Course for Registered Nurses - 
(B.N.) - 3 years 


A program extending over three ocademic 
years is offered to Regisfered Nurses who 
wish to obtain a Bachelor of Nursing 
degree. The course includes sfudies in 
the humanities. sciences and a nursing 
specia Ity. 
Diploma Courses for Registered Nurses - 
1 year 
(1) Nursing Service Adminisfrafion 
(2) Public Health Nursing 
(3) Teaching in Schools of Nursing 


For further information apply to: 
Director. School of Nursing 


DALHOUSIE UNIVERSITY 


Halifax, N.S. 


JANUARY 196i 



UNITED STATES 


AFF NURSES Here is the opportunity to further 
velop your professionol skills ond knowledge in 
, I,OOO-bed medicol center. We hove liberol personnel 
licies with premiums for evening and night tours. 
Jf nurses. residence, located in the midst of 33 
Irural and educational institutions, offers low.cost 
using adjacent to the Hospitals. Write for our booklet 
nursing opportunities. Feel free ta tell l.S what type 
sirian you ore seeking. Write: Director of Nursing, 
om 600, University Hospitals of Cleveland, University 
,cle, Clevelond, Oh io 44-06 15-36-1 G 


gistered Nurse (Scenic Oregon vacation play. 
:>und, skiing, swimming, booting & cultural 
ents) for 295-bed teoching unit on compus of 
.ive-rsity of Oregon medical school. Salary starts 
$525. Poy differentiol for nights ond evenings. 


liberal policy for advancement, vocations, sick 
leove, holidoys. Apply: Multnomoh Hospitol, Port- 
lond, Oregon. 97201. 15-38-1 


Staff Nurses: Live with your family in on attractive 
2 bedroom furnished home for $55 per month, 
including utilities, and work in a suburban Cleve- 
lond hospitol. Storting solory ronge $420 - $445 
with 6 and 12 month increments. Excellent transpor- 
tation to hospital door. Outstanding schools and 
cultural opportunities. Apply: Director of Nursing 
Service, Sunny Acres Hospitol, 4310 Richmond Rood, 
Clevelond, Ohio 44122. 15-36-1 E 


GRADUATE NURSES Wouldn't you like to work 
ot 0 modern 532-bed ocute Generol Teoching Hos- 
pitol where you would hove: (0) unlimited oppor- 
tunities for professional growth and advancement, 
(b) tuition poid for odvonced study, (c) storting 
solory of $429 per manrh (to rhose with pending 
registration as well), d) progressive personnel poli. 


ROYAL VICTORIA HOSPITAL 
SCHOOL OF NURSING 


MONTREAL, QUEBEC 


POSTGRADUATE COURSES 


1. 


(a) .Six month clinical course in Obstetrical Nursing. 
Classes - September and March. 


Two month clinical course in Gynecological Nursing. 
Classes following the six month course in Obstetrical 
Nursing. 
Eight week COurse in Care of the Premature Infant. 


(b) 


(c) 


2. Six month course in Operating Room Technique. 
Classes - September and March. 


3. Six month course in Theory and Practice in Psychiatric 
Nursing. 
Classes - September and March. 


For information and details of the courses, apply to: 


DIRECTOR OF NURSING 


ROYAL VICTORIA HOSPITAL 


Montreal, P.Q. 


\NUARY 1967 
I 


cies, (e) a choice of areas? For further information, 
write or call collect: Miss Louise Harrison, Director 
of Nursing Service, Mount Sinai Hospital, University 
Circle, Clevelond, Ohio 44106. Phone SWeetbrior 
5-6000. 15-36-1 D 


STAFF NURSES: University of Woshington. 320-bed 
modern, expanding Teaching and Research Hospital 
located on campus offers you an opportunity to 
join the staff in one of the following specialties: 
Clinical Research, Premature Center, Open Heart 
Surgery, Physical Medicine, Orthopedicts, Neurosur- 
gery, Adult and Child Psychiotry in addition to 
the Generol Services. Salary: $501 to $576. Unique 
benefit program includes free University courses after 
six months. For information on opportunities, write 
to: Mrs. Ruth Fine. Director of Nursing Services, 
University Hospital, 1959 N.E. Pacific Avenue, 
Seottle, Woshington 98105. 15-48-2D 


UNIVERSITY OF 
BRITISH COLUMBIA 


School of Nursing 


DEGREE COURSE IN BASIC 
NURSING 
DEGREE COURSE FOR 
GRADUATE NURSES 


Both of these courses lead to the 
B.S.N. degree. Graduates are pre- 
pared for public health as well as 
hospital nursing positions. 


DIPLOMA COURSES FOR 
GRADUATE NURSES 


I. Public Health Nursing. 
2. Administration of Hospital 
Nursing Units. 
3. Psychiatric Nursing. 


For information write to: 
The Director 


SCHOOL OF NURSING 
UNIVERSITY OF B.C. 
Vancouver 8, B.C. 


NOVA SCOTIA SANATORIUM 


KENTVlllE, N.S. 


Offers to Graduate Nurses a 
Three-Month Course in Tubercu- 
losis Nursing, including Immu- 
nology, Prevention, Medical and 
Surgical Treatment. 


For information apply to: 


Director of Nursing 


NOVA SCOTIA SANATORIUM 


Kentville, N.S. 


THE CANADIAN NURSE 79 



.......... 
.......... 
..

...... 
........... 
...++++++. 
.+++++++++ 
...+....+. 
..... 


Turns 
consume 
93 times their 
own weight 
in excess 
stomach 
acid! 


Laboratory tests show Tums neu- 
tralize 93 times their own weight 
in excess stomach acids, and that 
they maintain a balanced level for 
long periods, too. Tums go to work 
in 4 seconds on gas, heartburn and 
indigestion. And they taste pleas- 
antly minty, need no water and 
cost so very little. Those are the 
facts. So next time your tummy 
gives you a turn, give Tums a try. 
They're worth their weight in gold ! 
4lU
$.J 
FOR THE NURSE WHO 
DOESN'T HAVE EVERYTHING 


think how fasttheyll work 
on your tummy upsets! 


ASSISTOSCOPE ::
 


'- 


When your friends start 
"fishing" for what to give 
you this Christmas, hint 
to them how much you 
would like your personal 
lightweight stethoscope. 


ASSISTOSCOPE* - designed with the nurse in mind. 
Regularly $12.95, your Christmas stethoscope will cost 
you only $9.85 in your choice of white or black tubing. 
This offer expires December 24th. 


Also available in spe- 
cial sister model which 
fits easily under the 
coif. 


Order from t 
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M IIONTRUL 21 QUElIC 
2 _ 67 .TRADE MARl( 


ASSISTOSCOPE* 
Made in Canada 


80 THE CANADIAN NURSE 


Index 
to 
advertisers 
Jan uary 1967 


Abbot Laboratories Ltd. 
Ames Company of Canada Ltd. 
American Sterilizer Company 
Bland Uniforms Limited 
Government of Canada, Dept. of Labour 
Canadian University Service Overseas 
M. J. Chase Co. Inc. 
Charles E. Frosst & Co. 
Hollister Limited 
Lakeside Laboratories (Canada) Ltd. 
Lewis-Howe Company (Turns) 
C.V. Mosby Co. 
T.M. Pharmaco (Canada) Ltd 
J.T. Posey Company 
The Queen's Printer 
Reeves Company 
Uniforms Registered 
United Surgical Corporation 
Warner-Chilcott Labs. Co. Ltd. 
White Sister Uniforms Inc. 
Winley-Morris Co. Ltd. 


Advertising 
Manager 
Ruth H. Baumel, 
The Canadian Nurse 
50 The Driveway, 
Ottawa 4, Ontario 
Advertising Representatives 
Richard P. Wilson, 
219 East Lancaster Avenue, 
Ardmore, Penna. 19003 
Vanco Publications, 
170 The Donway West, 
Suite 408, Don Mills, Ont. 
Member of Canadian 
Circulation Audit Board Inc. 


Cover IV 


I J 
2 
9 
24 
57 
10 
6 
5 
80 
20, 21 
17 
18 
12 
19 
Cover III 
17 
57 
Cover II 
80 


I3E:J 


JANUARY 1%: 



February 1967 


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TI)_l.Q_"_'_Tr''' T\ 


The 
Canadian 
Nurse 



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nursing in the USSR 
drug addiction 
nurse and pharmacist 
- partners 
estrogen and the menopause 


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These three exquisite White Sister luxury professionals seen here (and many others) are available at fine uniform shops and department stores everywhere. 
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WHITE SISTER and THE CANADIAN NURSES ASSOCIATION 
are pleased to co-operate 
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at the 
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exp o 67 :W
 

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W.B. SAUNDERS COMPANY 
Philadelphia and London 


Saunders Texts - to enrich and 
expand your knowledge of nursing 


. . . 


Kron-Communication in Nursing 
By THORA KRON, R.N., B.S., formerly St. Luke's Hospital of Nursing. 
A New Book! From the author of Nursing Team Leadership, here 
is a practical guide for the nurse on how to write, speak - even 
nod! - with meaning. It skillfully shows how to have your thoughts 
and ideas "come accross." Mrs. Kron provides specific, how-to-do 
it information for achieving improved communication: how to 
become an intelligent listener - how to give a demonstration - 
how to make a speech - how to disagree agreeably - how to 
write minutes, memos, reports, letters. In each discussion the author 
points out common difficulties and makes concrete suggestions for 
improvement. The principles given throughout the text are sum- 
marized at the end. 244 pp., iIIus., $4.05. Just Published! 


The Nursing Clinics of North America 
The Nursing Clinics fill an urgent need by providing a single and 
continuing source of information about the latest nursing concepts 
and techniques. The forthcoming March issue contains two impor- 
tant symposia: The Nurse and the Law, with Jane C. Donahue, R.N., 
LL.B., as Guest Editor, and Radiation Uses and Hazards, with Eliza- 
beth H. Boeker, M.S.P.H., as Guest Editor. The 16 full-length, well- 
written articles range from "Professional Liability Insurance for 
Nurses" to "Nursing Care in Radium Therapy." As in every issue of 
Nursing Clinics, every article is written by an authority in the field, 
and the topics discussed are those suggested by subscribers. Every 
issue (4 per year) contains about 160 pages with no advertising, 
and is bound between hard covers. Annual subscription (4 issues) 
only. $13.00. Student Rate: $10.80. 
Howe-Nutrition for Practical Nurses 
By PHYLLIS S. HOWE, B.S., M.E., Contra Costa College and Diablo 
Valley College. This up-to-date New (4th) Edition provides the 
practical nurse with full information on normal nutrition, diet 
therapy, plus selection and care of food. Discussions range from 
normal metabolic functions to the boiling temperatures for fresh 
vegetables. The author takes care to fully explain menu planning 
for both normal and special cases. You will find over 35 imme- 
diately practical charts and tables on such subjects as: new storage 
times for frozen foods - modified diet patterns, such as sodium 
or fat restricted - percentages of nutrients derived from the 
basic four food groups - fatty acid and cholesterol content of 
foods. Exercises are included at the end of most chapters. 302 pp., 
iIIus., $4.05. New (4th) Edition - Just Published! 


Dennis- 
Psychology of Human Behavior for Nurses 
By Lorraine Bradt Dennis, B.S., R.N., M.S., Marymount Junior Col- 
lege. In the thoroughly revised and expanded New (3rd) Edition! 
of this delightful book, Mrs. Dennis has achieved much more than 
just another textbook. As well as providing an excellent practical 
introduction to psychology, this books helps the student nurse to 
find out what she really wants to know: Why do people behave 
as they do? How can I study most effectively? What can I do 
about my problems? Mrs. Dennis gives a clear and balanced 
picture of psychology. She discusses genetics and early develop- 
ment; learning, behavior, and personality; defense mechanisms; 
mental illness and the forms of psychotherapy; emotional maturity 
in marriage - all with wit, warmth, and wisdom. Teacher's 
Guide available. 289 pp., iIIus., $5.40. New (3rd) Edition - Just 
Published! 


Canadian Representative: Me Ainsh and Company, Ltd. 1835 Yonge St., Toronto 7 
BRUARY 1967 THE CANADIAN NURSE 1 



so soft. . . so soothing 


,
 



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2 THE CANADIAN NURSE FEBRUARY 1967 



The 
Canadian 
Nurse 


A monthly journal for the nurses of Canada published 
in English and French editions by the Canadian Nurses Association 


Volume 63, Number 2 


February 1967 


27 A Glimpse of Nursing in the USSR H. K. Mussallem 
34 Estrogen Replacement at Menopause D.C McEwen 
38 Estrogen and the Menopause .. J. Blanchet 
40 Nurse and Pharmacist - Partners J. L. Summers 
45 Tumors of the Skin P. J. Fitzpatrick 
48 Radiation Therapy for Skin Cancer ... D. Martyn 


The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 


4 Letters 
7 News 
18 Names 
21 Dates 


Cover photo courtesy of the USSR Embassy 


Executive Director: Heten K. Mussallem . 
Editor: Vlrglnta A. Llndabury . Assistant 
Editor: Glennts N. ZUm . Editorial Assistant: 
Carla D. Penn . Circutation Manager: Pier- 
rette Hotte . Advertising Manager: Ruth H. 
Baumel . Subscription Rates: Canada: One 
Year, $4.50; two years, $8.00. Foreign: One 
Year, 15.00; two years, 19.00. Single copies: 
50 cents each. Make cheques or money orders 
pa\able to The Canadian Nurse. Change of 
Address: Four weeks' notice and the otd 
address as well as the new are necessary. Not 
responsible for journats lost in mail due to 
errors in address. 
(i:) Canadian Nurses' Association. 1966 


:BRUARY 1967 


23 In A Capsule 
25 New Products 
51 Books 
54 Films 
55 Accession List 


Manuscript Infonnatlon: "The Canadian 
Nurse" welcomes unsolicited articles. AU 
manuscripts shoutd be typed, doubte-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial chanl(es. 
Photol(raphs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish aU articles sent, 
nor to indicate defimte dates of publication. 
Authorized as Second-Ctass Mail by the Post 
Office Department, Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway. 
Ottawa 4. Ontario. 


"The menopause is definitely 
obsolete today." 
This statement is from the pen 
of Robert A. Wilson, M.D., one of 
the best known proponents of 
estrogen replacement therapy for 
menopausal and postmenopausal 
women. 
Dr. Wilson and his group regard 
the menopause as a deficiency 
disease, rather than as an inevitable 
and irreversible condition. They 
believe it requires replacement 
therapy with hormones, just as 
diabetes mellitus requires insulin, 
and hypothyroidism, thyroid. 
Not all physicians agree with Dr. 
Wilson and his colleagues. Some 
strongly oppose the use of sex 
hormones to relieve menopausal 
symptoms. They defend this 
conservative position by saying that 
most of these symptoms result 
from psychic, rather than physical 
causes, and that the loss of female 
hormones at middle life is a normal 
phenomenon to which the body 
will adjust. 
Other physicians assume a 
moderate position, agreeing that 
hormone replacement is warranted 
when the vaginal cell count reveals 
estrogen deficiency, or when 
menopausal symptoms, such as hot 
flashes, backache due to 
osteoporosis, etc., become 
distressing to the patient. 
Many women, aware of the 
present controversy surrounding 
this topic will direct their questions 
to nurses. We can answer these 
questions objectively only if we 
have all pertinent facts. For this 
reason, we asked two gynecologists 
to present the pros and cons of 
estrogen replacement therapy. 
Dr. Donald C. McEwen, in 
"Estrogen Replacement Therapy at 
Menopause," claims that one 
woman in three suffers from ovarian 
deficiency and should be given 
estrogens for the balance of her life. 
Dr. Jean Blanchet, in "Estrogen 
and the Menopause," takes a more 
conservative approach. He believes 
that only a small percentage of 
menopausal patients have symptoms 
that warrant hormonal therapy. 
Whether or not the menopause 
becomes "obsolete" in future is not 
something that we can predict. 
However, with society's stress on 
youth and youthfulness it seems 
likely that we will hear more from 
the proponents of estrogen 
replacement therapy in the future. 
THE CANADIAN NURSE 3 



letters 


{ 


Letters to the editor are welcome. 
Only signed letters will be considered for publication 
Name will be withheld at the writer's request. 


Recommended reading 
Dear Editor: 
We were interested in the review of 
Joyce Travelbee's Interpersonal Aspects of 
Nursing (December 1966). Our first-year 
students have been discussing material 
from this text frequently in their course in 
nursing fundamentals and we have found 
the book has helped them to think and 
understand more about nursing, human 
beings, and human experiences such as 
illness and suffering. Although there are 
a few deficiencies in the text, we believe 
that these are greatly outweighed by its 
value in assisting nursing students "to 
achieve helping relationships with others." 
- Sister Patricia Marie, (Mrs.) B. Jones, 
L. Devereux, and (Mrs.) S. Dunning, 
Teachers of Fundamentals of Nursing, St. 
Joseph's School of Nursing, London, On- 
tario. 


Dear Editor: 
I would like to recommend a book that 
I believe every nurse should read and 
which, I hope, she in turn may persuade 
just one doctor to read. 
The name is, In Search of Sanity, by 
Gregory Stefan, and is published by the 
University Books, New Hyde Park, New 
York. 
Those nurses who have read it say it is 
unbelievable. It is a very easily read. book 
and 1 believe it is a very fitting successor 
to A Mind that Found Itself, by Clifford 
Beers, the old classic that did so much to 
change mental hospitals. 
Most book stores in large cities will order 
it: Book-of-the-Month will order it; and 
it is offered at a much cheaper price by 
The American Schizophrenic Foundation, 
Ann Arbor, Michigan, if one is a member. 
- (Mrs.) Marion Palmer, Alberta. 


No criticism 
Dear Editor: 
In your November 1966 issue there was 
an interesting letter from a distressed 
reader regarding her obstetrical care in 
an Ontario hospital with a comment from 
a Halifax nurse stating: "I don't know 
what hospitals are putting out for nurses 
these days." 
Recently, I had the privilege of enter- 
ing a modern obstetrical hospital in Hali- 
fax. The attention and treatment I received, 
from the first moment I entered the hos- 
pital with my suitcase, until I left with my 
4 THE CANADIAN NURSE 


firstborn son, was the happiest experience 
of my life, and I cannot honestly criticize 
any phase of my hospitalization. 
My admission was quickly, quietly, and 
efficiently performed by a student nurse, 
who first introduced herself, and explained 
each procedure before she began the rou- 
tine preparations. She took the time to help 
me with the breathing exercises with each 
labor pain, thus reinforcing the instructions 
I had received from my doctor prenatally. 
On transfer to the waiting or labor room, 
I received friendly, professional interest 
and care from both students and supervisor. 
At no time during the waiting period was 
there evidence of confusion; therefore, a 
feeling of confidence was transmitted to 
me and no panic or fear resulted. The 
case room nurse took the time to visit 
several times during the long night and 
informed me of my progress. When I was 
finally admitted to the labor room, I felt 
the staff were friends as well as capable, 
well-trained professional personnel. 
The postpartum and nursery care in this 
hospital were of the same high calibre. My 
questions regarding the baby's progress 
as well as my own were quickly answered. 
The staff certainly displayed patient in- 
terest during my hospital stay. 
After leaving the hospital, I felt sorry 
that I had received my training 15 years too 
soon, when the emphasis was on nursing 
service, with nursing education second. I 
believe that students today are receiving 
better education. They are given the op- 
portunity to provide nursing care, instead 
of orderly, maid or technician duties. 
J enjoy the articles published on hospital 
nursing. However, J would like to see some 
articles on public health nursing. - A 
Public Health Nurse, Nova Scotia. 


Obstetrics for men 
Dear Editor: 
I am writing to commend you on the 
article "Why Not Obstetric Nursing For 
Male Students?" (October t966). The 
article was short but presented a good ar- 
gument in favor of obstetrical training for 
male nursing students. The same desires 
that bring women to nursing also bring 
men and the same opportunities for train- 
ing should be available to both. I believe 
that having men in obstetrics could pos- 
sibly lend a sense of stability and security 
to childbirth for many mothers. - Marsha 
Smith, S.N., Providence School of Nursing, 
Sandusky, Ohio. 


University education I 
Dear Editor: 
After reading Miss Margaret Steed's arti- 
cle "A Goal for the Future," (December 
1966) we would like to express our view 
points. 
First, we found the article very interest 
ing. We really appreciated Miss Steed'! 
analysis of the different roles in the nursinl 
profession. Rather than being based or 
quantity, as in the past, nursing care will 
in the future, be viewed more from the 
aspect of quality. This will provide a ne\\ 
concept of nursing service - a team work 
ing together, centered on the needs of the 
patient. 
For this, the hospital administrator wi! 
have to be well informed of the necessit} 
to employ and to utilize the work potentia' 
of the two different <:ategories of nurses 
We questioned the guidance which shoule 
be given to candidates for either nursin! 
course. Students must know exactly the 
kind of role for which they will be educ. 
ated and the opportunities they will have 
to pursue their studies. We foresee hoy, 
difficult it will be for a diploma nurse 
to be accepted in a baccalaureate program 
after following a non-credit nursing course 
Though it may be a distant goal, we 
should prepare the public, teachers, and 
students, to participate in the reorganiza' i 
tion of the nursing profession. 
Miss Steed really opened the way, and 
we are looking forward to more article
 
in the same light. - Nicole Lambert, Gi. 
neUe Lefebvre and Louise Poirier, 4th 
year students in the baccalaureate pro 
gram, Institute Marguerite d'Youville. 
Montreal. 


Dear Editor: 
J want to congratulate Miss Margaret 
Steed on her very fine article, "A Goal 
for the Future" (December, 1966). 
I have read this article with much in- 
terest and believe that she has made many 
comments which present her true thoughts 
on nursing at the present time. 
In the section "Education for Practice," 
which is well outlined, she presents facts 
that should be a stimulus to many young 
nurses who wish to map out a goal for 
their future. In the paragraph "Distinctions 
in Role and Practice," she has endeavored 
to bring out the full meaning of the im- 
portance of the nurse in practice. I was 
very interested in her comment on team 
nursing. 
The final paragraph, entitled "The Way 
(Continued on page 6) 
FEBRUARY 1967 




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6 THE CANADIAN NURSE 


letters 


(Continued from page 4) 
Ahead," is brief, concise. and very thought 
provoking. 
I will recommend this article to be read 
by all the students and I am very happy 
that she has taken her pen and com- 
posed such a splendid article. - Rahno 
M. Beamish, Director of Nursing, Kit- 
chener-Waterloo Hospital. Kitchener. Onto 


Dear Editor: 
The December issue, which describes bac- 
calaureate education, contains information 
which is of great value for the recruitment 
and dissemination of information to the 
members of the profession. 
We were a little disappointed with the 
writeup given to Mount Saint Vincent Uni- 
versity. When the original draft was sent 
for our review and correction in September, 
we made several changes. Yet, the uncor- 
rected draft appeared in the journal. We 
bring this to your attention knowing that 
THE CANADIAN NURSE, as the official organ 
of the Association, endeavors to publish 
accurate and up-to-date information. 
We look forward to each new edition uf 
the journal for the stimulating and varied 
articles it contains. - Sister Jean Eudes, 
R.N., M.S., Director of Nursing. 


The correct description of Moullt Sailll 
Vincent Ulliversity is provided here for the 
benefit of readers. - The Editors. 
Mount Saint Vincent University is the 
only independent women's college in Cana- 
da. It is a Catholic institution for the 
higher education of women and is cond- 
ucted by the Sisters of Charity. Located ill 
the village of Rockingham, about 20 min- 
utes from downtown Halifax by car, the 
campus overlooks Bedford Basin. The Uni- 
versity is growing rapidly; a new tower 
residence and a Student Union building 
hm'e been completed recently. Plans are 
under consideration for a new academic 
building with adjacent professional build- 
ings. Sister Jean Eudes, Director of the 
School of Nursing, is responsible to the 
Academic Dean who, in turn, reports 
directly to the President of the University. 
The basic nursing program is a four- 
year, integrated program leading to a 
Bachelor of Science in Nursing (B.Sc.N.) 
degree. Mount Saint Vincent University 
was the first university in Nova Scotia to 
offer an integrated nursing degree pro- 
gram. The course includes three summer 
sessions. Hospital practice is given in Hali- 
fax hospitals and health agencies and is 
under the direct supervision of the Uni- 
versity nursing faculty. 
A degree program is also open to reg- 
istered nurses who have completed one- 
year university courses in a nursing special- 
ty. The nurse who registers in this program 


is required to complete 10 courses i, 
science and liberal arts subjects. The pro 
gram, instituted to meet a pressing need fo 
nurses with degrees in administrative all. 
teaching positions in Nova Scotia, will b 
offered for a limited time. No certificat 
courses are m'ailable. 
Admission requirements to the basic 4 
year integrated program include Senio 
Matriculation (Nova Scotia grade 12) wit 
certain specific high school subjects. A ne} 
tower residence with single room accom 
modation is available on campus and st" 
dents may live in if they so desire. Marrie. 
women may apply, and, although the UIII 
}'ersity is primarily for women, men ma 
apply for certain courses. 
A bout 20 students are admitted to eac. 
new class. It is anticipated that the ScllOC 
will enlarge its facilities. Illterested cand. 
dates should write to the Director, Schoc 
of Nursing, Mount Saint Vincent Unive, 
sity, Halifax, N.S. 


"Grumps!" 
Dear Editor: 
Why is it that you always publish letter 
saying what a good magazine you have 
Doesn't anyone ever say anything critical 
Every issue it's "bouquets" and "COlT 
pliments." Why don't we ever see "gal 
bage" and "grumps"? 
Maybe it's because readers like myself 
who see plenty to criticize, get in the hab 
of tossing your magazine into the wast 
basket and turning to the funny pap::rs fo 
our amusement. 
Not that THF CANADIAN NURSE isn't amu
 
ing - at least to a certain extent. 
The bombastic. amateur-psychologist pros 
is really quite a laugh, as long as one doesn 
read too much of it or take it too seriousl) 
Take this. for a representative exampl 
from your last issue: 
"An analysis of the aspects of the nursin 
proces
 as related to patient care reveaJ 
a range of activities extending along 
continuum from the simplest to the mOl 
complex." In other words, in treating p, 
tients, a nurse has easy jobs and har 
ones. 
You've been preaching higher educatio 
for some time - in fact it seems to be th 
major theme of your magazine - but 
Miss Margaret Steed's article (which 
quoted from) is an indication of what hal 
pens after higher education, then heave 
preserve us from it. 
I have one more grump. One gels ver 
tired of seeing, hearing, and reading abol 
professionalism, and what behavior can b 
classified as professional, and is nursing 
profession or is it not. A nurse is a nurs. 
and whether she belongs to a profession ( 
a labor force, she's got to do the sam 
things when she goes to work. What i 
fact you're talking about is status; which 
to say, you're encouraging snobbery, n( 
professionalism. - Sharon Johnston. R.N 
Montreal, Quebec. 


FEBRUARY 196' 



news 



ore Cooperation 
:MA-CNA-CHA 
The Canadian Medical Association has 
leen asked to form a steering committee 
o prepare for a conference on Hospital- 
.tedical Staff relationships. The CMA 
viii invite the Canadian Nurses' Associa- 
ion and the Canadian Hospital Association 
o name members to the committee. 
The main object of the conference would 
Ie to explain the place and role in the 
lospital of administrative personnel, med- 
cal staff, and nursing staff, and to em- 
,hasize the relationship between the three. 
,ointing out the essential need for com- 
Ilete understanding and cooperation to 
Irrive at the desired result of more ef- 
icient operation to produce the best quality 
If patient care. 
The conference was suggested by a joint 
'ommittee of the CHA, CMA, and CNA at 
, meeting in December, 1966. 
The joint committee has also recom- 
nended that the three national associations 
Ie given the opportunity to participate in 
ach other's annual or biennial meetings. 
)r. L.O. Bradley, of the CHA, stated that 
here is very little cross representation at 
mnual meetings of either the national 
)r the provincial associations and that 
vhen such representation existed it was 
.eJdom that the representatives were given 
In opportunity to report the activities of 
heir associations or to point out the pro- 
Ilems that may exist between the organiza- 
ions. 


,tudy on Non-Nursing 
\ctivities in H.C. 
"In determining the number of hours of 
mrsing care per patient day, many hos- 
litals do not exclude the time spent by 
mrsing staff performing duties that are 
110re correctly the function of other depart- 
l1ents." 


This is the conclusion of a joint com- 
l1ittee of the Registered Nurses' Associa- 
ion of British Columbia and the B.c. 
Hospital Association who have recently 
'ompleted an investigation of some of the 
ifeas in which nurses assist. The commit- 
ee consulted representatives of dietary, 
lousekeeping, pharmacy, laboratory, x-ray 
md social service and have published a 
.ix-page booklet outlining non-nursing 
juties that nurses are called on to assume 
n these areas. 
The committee has recommended that 
'each hospital give serious consideration 
o the question of whether nursing person- 
FEBRUARY 1967 


RN is Expo 67 Hostess 


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This Pdtient at the Montreal Protestant 
Hospital is being taken on a verbal tour 
of Expo 67 by a hostess who is quite at 
home at the hospital bedside. Barabara F. 
Stewart, a graduate of The Montreal Gen- 
eral Hospital and the McGill School for 
Graduate Nurses. is one of the Expo 67 
hostesses who is presently informing North 
Americans about the coming Exposition. 
Miss Stewart, who speaks English, 
French and Italian fluently, was employed 
with the Montreal Branch of the Victorian 


, 


. 


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, f
' 
Order of Nurses prior to joining the Expo 
staff. Her wide professional experience at 
hospitals in Montreal, Atlanta, Georgia, 
Lausanne and Geneva, Switzerland, and 
her travels in 16 other countries give her 
a valuable background for meeting the 
persons of various ethnic groups who will 
attend Expo, April 28 to October 27. 
"Being hostess at Expo is a once-in-a- 
lifetime event," says Miss Stewart. "When 
it is over, I plan to return to nursing, 
since it is my-true métier." 


'. 


nel are being utilized to the best advantage, 
and when nursing personnel must be as- 
signed non-nursing duties, the time so 
spent be subtracted when computing the 
actual nursing time being spent on nursing 
care." 
The committee recognizes that problems 
may exist in other areas, such as clerical, 
porte ring, messengering, and so on, and 
will continue their investigations into these 
areas at a later time. 


SRNA Prepares Guide 
for Refresher Courses 
The Saskatchewan Registered Nurses' 
Association released a new 12-page Guide 
for Refresher Courses for lnactil'e Nurses 
in December, 1966. The booklet will be 
used as a guide to establish programs to 


help inactive nurses return to nursing. 
The booklet was prepared by the SRNA 
Committee on Nursing Service. Nurses who 
have not been engaged in nursing for a 
period of five years or longer are required 
to have a refresher course before returning 
to practice, and the SRNA has undertaken to 
give direction and help with the organization 
of sU'ch a program through this means. The 
association will also assist in finding suitable 
staff to carry out the program to help in- 
active nurses return to nursing. 
The Guide recommends that hospitals of 
not less than 30 beds and subject to appro- 
val by the SRNA may set up programs. Fees 
paid for the course would generally make the 
programs self-supporting. The length of the 
experience would depend on the needs of the 
individual, but a minimum of 120 hours of 
selected and supervised practice over a 
THE CANADIAN NURSE 7 



news 


period of not more than 6 weeks is suggest- 
ed. Approximately 30 hours of theory should 
be correlated with the practice. 
Guidelines for course content are also 
included in the booklet. 


United Nurses of Montreal 
Seek Accreditation 
The leg31 counsel for the newly-organized 
United Nurses of Montreal, Mr. Phil Cutter, 
has announced that the UNM will seek to 
obtain accreditation from the Quebec 
Labour Relations Board to negotiate as 
bargaining agent for the 28 Montre31 hos- 
pitals in which English-speaking nurses are 
in the majority. 
The gener31 meeting, in setting up the 
constitution, stipulated that 311 nurses who 
are English-speaking members of the ANPQ 
could join the UNM. In fact, the UNM 
was founded following a meeting of the 
English-speaking chapter of district 11 at 
which 1,200 nurses resolved to form a union 
to negotiate on working conditions. 
At a meeting of some 600 nurses on 
December 14, Miss Moyra Allen, instructor 
at the McGill School for Graduate Nurses 
and president of the English-speaking 
chapter of District 11 of the Association of 
Nurses of the Province of Quebec, was 
elected president of the UNM. Other offi- 
cers elected were: Miss Terry MacMillen, 
vice-president; Miss L. Short, secretary; Miss 
C. Mutmuir, treasurer; and Misses T. Ni- 
chols, M. Powers, and A. H31I, directors. 
At present the UNM has 31ready recruited 
a majority of the approximately 4,800 
English-speaking nurses who work in the 
Montreal region. 
Another group of nurses, the Metropoli- 
tan Association of Nurses, was formed in 
Montre31 at the end of November, 1966, 
and is 31so seeking accreditation from the 
Labour Relations Board. 


Nurses Await Satisfactory 
Negotiations with Employers 
Ontario public he31th nurses in the coun- 
ties of Halton, Stormont-Dundas-Glengarry, 
and Peel are still awaiting satisfactory 
outcomes to their negotiations with 
employers. 
In Halton County, the nurses returned 
to work on November 7th, with the verbal 
understanding that negotiations would start 
immediately on their return. On November 
23 the nurses learned that the Council had 
back-tracked on its promise. The County 
Council announced that it would not nego- 
tiate with the nurses until they had become 
certified under the Labour Relations Act. 
The H31ton County public health nurses 
are presently considering alternative courses 


8 THE CANADIAN NURSE 


of action. They have no immediate plans 
for certification. 
In the United Counties of Stormont- 
Dundas-Glengarry, the public he31th nurses 
returned to work on December 19. three 
months after handing in their resignations 
when employers refused to negotiate sala- 
ries and working conditions with them. They 
returned to work with a written promise 
that a negotiating committee would be 
established, and that the board was prepared 
"to negotIate in good faith" with them. 
At press-time, no employer-employee ne- 
gotiations had been initiated. 
In Peel County, which has 31so been grey- 
listed by RNAO, public health nurses are 
awaiting the report of a conciliator, who 
was appointed in November by the Ontario 
Labour Relations Board. It is probable that 
a conciliation board will be set up as a 
recommendation of this report. According 
to RNAO News, "the ability of Peel County 
Board of Health to negotiate in good faith 
has not yet been demonstrated and the 
situation is becoming criticaL" 


"No Smoking" Literature 
For Bedside Tables 
A joint committee of the Canadian Med- 
ical Association, the Canadian Hospital 
Association and the Canadian Nurses' As- 
sociation suggested that the three associa- 
tions should support the CMA campaign 
to publicize the harmful effects of smok- 
ing. 
At a meeting early in December the com- 
mittee agreed that the CMA, working with 
the Department of National Health and 
Welfare, was the appropriate body to notify 
the public of the health hazaJd from smok- 
ing. 
It was also suggested that the CHA 
could recommend to hospitals that a notice 
prepared "by the Department of National 
Health and endorsed by the CMA and 
CHA be placed on all bedside tables in 
hospitals. 


Hospital Fringe Benefits 
Below National Averagt> 
In t 965, Canadian hospitals paid an 
average of $689 in fringe benefits for each 
employee. However, this was barely half 
the national average of $ t ,350 per employee 
of other Canadian industries. 
These figures were disclosed in the 
December issue of Hospital Administration 
in Canada, which pointed out that 20.8 
percent of total hospital payroll costs 
went toward fringe benefits. The overall 
national average of fringe benefits to pay- 
roll is 25.2 percent. 
According to the article, the highest 
percentage of the fringe benefits given 
to hospital employees was for paid time 
off work. This was much higher than for 
any other group. Paid time off work in- 


c1udes vacation pay, holidays with pa} 
rest periods and coffee breaks, paid tim 
off for death in the family, jury and militar 
duty. 
Hospitals rank very low in percentag 
of payroll benefits devoted to unemplo}' 
ment and workmen's compensation and i 
contributary pension and other welfar 
programs in comparison to the nationa 
average. 
Hospitals ranked higher in other non 
cash benefits, such as cafeteria losse! 
medical supplies to employees, parkin
 
education, and laundry services. 
The article was based on a study b 
The Thorn Group Ltd., managemer 
consultants, Toronto. This was the firm' 
sixth report on "Employer fringe benef] 
costs in Canada," but the first time th
 
hospitals were included in the survey. 


National Ht>alth and Welfare 
The Year in Review 
The year 1966 was a year of hand 
across the sea and expanded social secunt 
across the nation for the Department c 
National Health and Welfare. 
On the international scene, the Emel 
gency Health Services Division sent I 
emergency hospitals to Viet Nam and DJ 
Joseph W. Willard, Deputy Minister (] 
Welfare, was elected chairman of th 
Executive Board of UNICEF. 
In the field of social security, the newe! 
development was the announcement of th 
Guaranteed Income Supplement, whic 
will provide up to $360 a year to abot 
900,000 Old Age Security pensioners wit 
modest or no other income. 
The major expansion of the department' 
health facilities was completion of th 
Environmental Health Centre in Oltaw
 
opened officially in October by the: M 
nister, Hon. Allan J. MacEachen. The ne\ 
building accomodates laboratories and 01 
fices of the Occupational Health Divisior 
the Public Health Engineering Divisio 
and the Consultant in Aerospace Medicinf 
The Medical Care Act was passed b 
Parliament at the end of the year and wil 
become operative not later than July I 
1968. The provisions of this statute wer 
based on four principles outlined by th 
Prime Minister in July, 1965, when he an 
nounced the government's intention 10 
make federal contributions for provinciall 
administered medical care programs avaï 
able to the provinces. For provinces t, 
benefit from the federal program, provin 
cial plans must provide comprehensiv 
physicians' services to all residents of th 
province without regard to age, abilit 
to payor other circumstances. Further 
more, the Act empowers the governmen 
under stated circumstances to include add 
tional health services. Provincial program 
must be publicly administered and bene 
(Continued on page n 
FEBRUARY 196: 



Blands of Montreal 
FEATURE STYLE, COMFORT AND LONG WEAR 


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:EBRUARY 1%7 


THE CANADIAN NURSE 9 



\;\'ORKSHOPS FOR 


DIRECTORS AND 


D 

 


ASSIST ANT DIRECTORS 


Six regionol workshops for directors or ossistont directors of nursing service in hospitals 
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through 
the Problem-Solving Method. 
The workshops aim at stimulating directors and assistant directors of nursing service to use 
the problem-solving approach in the administration of nursing services. Key speakers will 
discuss techniques of problem-solving. Major problems in nursing services in Canada will be 
discussed. n.rough group work and case study methods skills in problem-solving will be 
developed. 


Two workshops will 
Region 
Atlantic 
West 
And four in the Fall: 
Region 
Ontario 
Mid-West 
Ontario 
Quebec 


be held in the Spring: 
City 
Halifax 
Vancouver 


Dote 
April 11-14, 1967 
May 2-5, 1967 


City 
Toronto 
Regina 
London 
Quebec City 


Dote 
October 17-20, 1967 
October 24-27, 1967 
November 7-10, 1967 
Nov. 28-Dec. 1, 1967 


Exact locations will be announced later. 
The workshop to be held in Quebec city will be conducted in the French language only. 
English language nurses in the province of Quebec are invited to attend one of the work- 
shops held in Ontario. French language nurses in New Brunswick are invited to attend the 
workshop in Quebec city. 
The workshops are open to directo
 or assistant directors of nursing service in hospitals. 
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature 
of the workshop only full-time registrants can be accepted. 
Here is an opportunity for directors and assistant directors of nursing service: 
. to sharpen skills in problem-solving within a 
"training laboratory" environment; 
. to learn how problem-solving can be facilitated through group work; 
. to stimulate orderly thinking toward the improvement of 
nursing service; 
. to identify the leadership role of the director of nursing service 
and/or assistant director of nursing service in problem-solving and 
decision making. 
Interested! then plan now to attend the workshop in your area. Register early and avoid 
disappointment. 


I wish to register for the CNA Regional Workshop for Directors or 
Assistant Directors of Nursing Service in Hospitals held in : 
o Halifax 0 Regina 
o Vancouver 0 London 
o Toronto 0 Quebec City 


Name 


Title of Position 


Years in Position 


Name of Hospital 
City or Town 
Qualifications beyond RN 
I enclose postal note (bank money order) for $ 
payable to the Canadian Nurses' Association. 


Number of Beds 


MAIL TO: 


CANADIAN NURSES' ASSOCIATION 
50 The Driveway 
Ottawa 4, Ontario 


10 THE CANADIAN NURSE 


news 


(Continued from paRe 8) 


fits must be portable from province te 
province, thus ensuring the national char- 
acter of the plan. The amount of the 
federal contribution will be based on the 
average cost of insured services in particip. 
ating provinces and will be calculated on 
a per capita basis. 
Canada's need for more trained health 
personnel was recognized in July with the 
passage of the Health Resources Fund 
Act. It provides a fund of $500,OOO,OOC 
over 15 years to assist in acquisition. con. 
struction, renovation and equipping 01 
health training facilities and research insti 
tutions. The federal payments for an) 
projects will be up to 50 percent of the 
total cost. The balance need not, as ill 
some federal-provincial programs, be 
provided by the provincial government, 
but may be supplied by any source designat- 
ed by the province. 
The Smoking and Health Program added 
two major weapons to its arsenal - a 
teacher's kit with completely Canadian 
content and an animated film, The Drag. 
The film, directed at teenagers, is bein
 
given theatrical screening across Canada. 
A strong new link in the chain connecting 
smoking and fatal diseases such as lung 
cancer was forged by a recently published I 
report of the department's Epidemiolog) 
Division. It gives the results of a study 
conducted from 1956 to 1962 on the mort- 
ality rates of smokers compared to non- 
smokers. Those surveyed were recipient
 
of pensions from the Department of Vete. 
rans Affairs. 
The new Canada Assistance Plan is a 
federal-provincial measure designed to in- 
tegrate existing public assistance programs 
and to share for the first time the cost of 
Mothers Allowances, health care, exten- 
sions of welfare and administrative services. 
and work activity projects. The program 
places emphasis on the rehabilitation of 
recipients to overcome and reduce depen- 
dency on assistance and represents a signi- 
ficant step in updating and rounding out 
Canada's social security system. 
It was a year of intensive activity for 
the Canada Pension Plan. National head- 
quarters in Ottawa and 37 district of- 
fices across the country were established 
and began processing the first applications 
for retirement pensions. which started 
January, 1967. Services provided to the 
public by staff of these offices include: 
receiving applications for benefits, assist- 
ing in the completion of applications, coun- 
seling, explaining pension computations 
and furnishing other information on the 
Plan. 


(Continued 011 page 12) 
FEBRUARY 1967 



Making the Best Better 


/". 


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I 


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" 


New 7th Edition! 
TEXTBOOK OF ANATOMY 
AND PHYSIOLOGY 


Now in a new 7th edition, this highly successful text provides 
the basic facts and principles of body structure and function 
in a well-organized form. Student comprehension and interest 
are increased through the two-color format and the superb 
selection of illustrations, as well as the newly expanded full- 
color Trans-Vision@ insert. This new edition gives thorough 
coverage to the newer findings in all areas of anatomy and 
physiology, omits the abundant detail which tends to confuse 
students and places more emphasis on organizing facts about 
explicitly stated principles. New learning aids include a list 
of abbreviations widely used in physiology and a list of 
common prefixes in scientific words. A new test manual is 
provided without charge to all instructors who use this book 
as the required text. 
By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. lIIustrat.d by ERNEST W. 
BECK. Publication date: April, 1967. 7.... edition, approx. 570 pag.., 7" x 1a'. 
About $8.40. 


New 7th Edition! 
ANATOMY AND PHYSIOLOGY 
LABORATORY MANUAL 


The new 7th edition of this popular laboratory manual 
presents a streamlined method for recording results of experi- 
ments and interpretations of those results, includes a greater 
number of physiological experiments than previous editions, 
suggests more audiovisual aids, includes chapter outlines and 
self-tests. A time-saving answer book is provided without 
charge to all instructors adopting this manual. 
By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. lIIustrat.d by ERNEST W. 
BECK. Publication date: May, 1967, 7111 edition. About $4.00. 


The C. V. MOSBY Company, ltd. Publishers 


New editions of outstandingly successful 
Mosby texts-improved and perfected 
to meet your changing needs 


New 4th Edition! 
MEDICAL-SURGICAL NURSING 


The most widely adopted text of its kind, now in a new 
4th edition, this authoritative text continues to offer the 
most practical, up-to-date integration of all information 
required for the effective care and management of the 
patient who is medically ill and/or undergoing surgical 
treatment. 


This new 4th edition has been improved and perfected, 
providing you with a wealth of new material on patient 
care. Now more than ever before, you can give your 
students a thorough understanding of "total patient 
care." All chapters and illustrations have been exten- 
sively revised in the light of today's changing concepts 
in health care and medical treatment. 
Throughout this extensive revision two important con- 
cepts in nursing care have been stressed: ( 1) the en- 
larged concept of prevention-prevention of progression 
or of complications of disease, and prevention of limita- 
tions in living if handicaps do occur; and (2) the role 
the patient's family plays in the patient's progress. 
You will find instruction in the actual clinical situation 
made easier through the inclusion of the principles of 
anatomy, physiology and the social sciences as they 
relate to care of sick people on each age level. Addi- 
tional aids are the two-color format, assuring greater 
readability, the study questions at the beginning of each 
chapter, and a detailed bibliography. A 32-page Teach- 
ing Guide is given to all instructors adopting this text. 


By KATHLEEN NEWTON SHAFER, R.N., M.A.; JANET R. SAWYER, R.N., 
A.M.; AUDREY M. McCLUSKEY, R.N., M.A., Sc.M.Hyg.; and EDNA LlFGREN 
BECK, R.N., M.A. Publication date: April, 1967. 4111 edition, apprax. 860 
pag.., 7" x 10", 236 illustrations. About $10.80. 


A New Book! 
PRINCIPLES OF OBSTETRICS AND 
GYNECOLOGY FOR NURSES 


Utilizing a concise, fundamental approach to obstetrics 
and gynecology, this new book can give YOUT students 
an understanding of the foundations, theory and clinical 
nursing practice as they concern fetal development, de- 
livery, gynecologic complications and pathology. The 
fundamental concepts and principles necessary for the 
basics of nursing of the mother and child are clearly 
defined. 


By JOSEPHINE IORIO, R.N. Publication date: May, 1967. Apprax. 332 
pag.., 6Y.' x 9%", 75 Illustrations. About $7.40. 


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12 THE CANADIAN NURSE 


news 


(Continued from page 10) 


No. 
169 


Catholic Nurses Meet 
The Association of Catholic Nurses of 
Canada, in conjunction with the National 
Council of Catholic Nurses of the United 
States. will host the North American 
regional congress. The congress will be 
held in Montreal June 20 to 22, 1967 within 
the framework of the Expo 67 theme. The 
congress theme will be "Suffering of Man 
and His World." 
His Eminence, Cardinal Léger, Father 
Tillard, O.P., and Dr. Eleanor C. Lamber- 
tson, dean of the faculty of nursing at Co- 
lumbia University in New York. will be 
among the invited speakers. 
The program will include seminars as well 
as group meetings. An invitation to the 
congress is extended to Catholic nurses all 
over the world. 


Barrie Students Raise Funds 
for Overseas Student 
"Our Chinese Girl" is the favorite ex- 
pression among nursing students at the 
Royal Victoria. Hospital in Barrie, Onl. 
Since Miss Catherine M. Brown, director of 
the Royal Victoria Regional School of Nurs- 
ing, informed the students of a letter of 
application from Miss Cecilia Chiu, a For- 
mosan girl, the students have adopted a big 
sister attitude toward her. 
They have taken it upon themselves, as- 
sisted by the Royal Victoria Hospital School 
of Nursing, to raise money to assist Miss 
Chiu with her entrance fees and expenses. 
Miss Brown received Miss Chiu's letter of 
application in July. Her academic standing 
was acceptable by provincial standards, and 
the young lady would have been accepted 
for the first class of the new regional school. 
However, the time-consuming factors of 
mail delivery overseas and the trip to Barrie 
would have made her arrive too late to 
enter that class. 
Miss Chiu, having been informed that the 
school entrance fee was $200, and knowing 
that she would need money to live on while 
in Canada, believed that she would need 
another $500. She mentioned in her letters 
that she had enough money saved for her 
passage to Toronto, and that she would 
keep her secretarial position in Formosa 
during this year, but she would still likely 
need financial help. 
It was at this point that the studen" 
began their money-raising campaign. The 
students have a permanent baby-sitting pro- 
gram whereby one-half the money goes to 
the fund. They also have held a benefit 
dance, a hay ride, a hockey raffle and a 
hockey pool. Through the generosity of a 
local service ..tat ion operator. the ..tudenls 


held a gas-o-rama at which they received 
a commission on every gallon of gas they 
pumped. They have also received several 
offers of help and several donations from 
individuals in the area. 
To date, they have raised $336, with a 
goal of $500-$600. They are still looking 
for imaginative ways to raise the resl. 
When asked why they were doing this for 
a girl they had never seen, Miss Mary 
Ellen Empringham, chairman of the fund- 
raising committee replied: "Because she has 
made such an earnest effort to manage her 
passage here. we do not feel she should be 
deprived of her wish. We also believe that 
nurses are to help people and, even though 
we are far from being nurses, we believe thi.. 
campaign, its challenge, and the accomplish- 
ment of our goal will furnish a test of our 
qualities and characters as future nurse..... 


New Method for 
Early Cancer Detection 
Investigations that began JO years 
ago at the Royal Victoria Hospital in 
Montreal are leading researchers to believe 
that "heat pictures" or thermograms of 
the thorax could be the best method of 
detecting breast cancers, the commonest 
tumors in women. 
Detection of breast cancer at a very early 
stage is not usually possible by ordinary 
techniques. However, since at least 90 per- 
cent of patients with breast cancer show ab- 
normal temperature variations of 10C or 
more in the breast skin over the lesion, 
doctors feel that this sign should be ex- 
ploited as for as possible. There is also 
evidence that the degree of malignancy is 
related to the degree of temperature eleva- 
tion. 
Now, a Canadian breast surgeon, Ray 
N. Lawson, has developed a method of 
producing heat pictures of the thorax that 
clearly portrays these temperature varia- 
tions. Dr. Lawson uses infra-red radiation 
devices plus a scanning or image-producing 
device that gives a two-dimensional map 
or thermogram. The device is similar to 
the radar screens used on ships or in air- 
plane towers, except that it is sensitive to 
heat variations. 
Investigations are currently underway to 
engineer improved electronic gear for 
displaying temperature patterns. "At pre- 
sent, military needs have a much higher 
priority than those of medical research," 
says Dr. Lawson. "Knowledge of certain 
new advances in thermal physics that would 
help advance our techniques is presently 
unavailable to medical researchers." 
Engineering research in thermdl physics 
is also particularly costly. Since Novem- 
ber, 1966, however, the American Cancer 
Society has been sponsoring a program to 
evaluate the use of thermography diagnosis 
in breast cancer, and some enthusiastic 
reports have already been given. 


FEBRUARY 1967 



news 


Using new techniques, scanning of large 
body surfaces takes less than a minute and 
permanent records of the area can be 
available for study 10 seconds after the 
scan. 
The new scanning techniques would also 
be applicable in other medical areas, such 
as placenta location in obstetrics, arthritic 
disease, dennatology and arteriosclerosis. 
It is now established in some clinics as a 
most useful aid in cancer detection, evalua- 
tion of benign conditions. and follow-up 
surveys searching for cancer spread. 


Toronto's Street Haven 
Started by RN 
Street Haven, a refuge in Toronto for 
prostitutes, drug addicts, alcoholics, and 
lesbians, owes its existence to a thirty-year 
old registered nurse who has a big heart 
and a faith in human nature to match. 
Peggy Ann Walpole, a graduate of St. 
Michael's Hospital School of Nursing in 
Toronto, and now executive director of 
Street Haven, started this refuge for female 
offenders in March, 1965. At that time 
the Haven consisted of one room - an 
unused beverage room in an old hotel - 
and had no official financial backing. 
Today, as a non-sectarian organization 
that uses the services of more than 50 
volunteer workers, the Haven occupies 
2,000 square feet above a store in down- 
town Toronto and contains bright, airy 
living rooms, an office, and a large kitchen. 
A monthly budget of $2,100 is made up of 
grants from the Alcoholism and Drug Ad- 
diction Research Foundation, Eaton's, priv- 
ate donors, and the United Church of 
Canada. 
The idea of establishing a refuge for 
Women who are "at the bottom of the lad- 
der" came to Miss Walpole after she had 
read The Junkie Priest, by Father Daniel 
Egan, founder of a similar haven in New 
York. Before reading this book, she had 
become convinced that something other 
than the usual halfway house was needed 
for women who had been caught in the 
web of narcotic addiction, prostitution, 
and petty crime. 
"No woman is an addict or a prostitute 
by nature," says Miss Walpole, who en- 
countered many such persons as a nurse 
at St. Michael's, at a halfway house in 
Toronto, and at the city's Don Jail. "Usual- 
ly she is pressured into the life. All too 
often she is released from prison without 
money, without worthwhile friends, with- 
out a job, and with no place to go. When 
she returns to crime, it is for survivaL" 
The average age of the girls at the Haven 
is 23. Some come voluntarily for assistance, 
others are escorted by the police, or are 
FEBRUARY 1967 


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Miss Peggy Ann Walpole, R.N., founder and executive director of Street Haven. 
a Toronto refuge for female offenders, chats with luncheon visitors in the 
Haven's public tearoom. Eaton's of Canada helped furnish this room. 


referred by the courts. Recently, two young 
girls were brought to the Haven by an old 
prostitute from a brothel where the girls 
had been living. 
At the Haven. the girls are accepted and 
given individual attention by Miss Walpole 
and her volunteers. The informal therapy 
consists of discussion groups, including 
Sunday evening sessions with young men 
from a Youth Anonymous group from 
Hamilton; recreational activities. such as 
bridge, ping-pong, darts, and a weekly 
hootenanny; instruction in the techniques 
of serving and cooking for Street Haven's 
tearoom, which is open to the public; and 
arts and crafts. Some girls are directed to 
adult retraining centers for clerical courses; 
others are assigned small housekeeping 
responsibilities in the Haven. 
The volunteers, all of whom are inex- 
perienced when they come to Street Haven, 
involve themselves in all aspects of work. 
They write to and visit girls who are in 
hospital and jail; arrange to meet them on 
discharge from jail; pick up donations of 
furniture and clothing; assist with secre- 
tarial work; go on emergency calls to hos- 
pitals, and often to the "corners"; and 
attend court sessions. 
Nurses interested in volunteer work at 
the Haven should write: Street Haven, 2 
Teraulay Street, Toronto, Ontario. 


B.G.H. Receives 
Building Grant 
The Belleville General Hospital has been 
awarded a federal grant of $995,900 for 
construction and renovation programs. 
The hospital will add a new wing to its 
present building to provide space for 293 
active treatment beds and 44 beds for the 
care of psychiatric patients. The wing will 
also contain new operating rooms, x-ray 
department. laboratories and other facilities. 


Renovations to be carried out In the 
existing north wing will provide for an 
86-bed chronic care unit. Other renovations 
will include improvements to nurses' sta- 
tions. the enlargement of the physiotherapy 
department. modernization of the laundry, 
and additional space for the kitchen. 
Work is already underway and is schedul- 
ed for completion about November, 1967. 


New Services at 
L'lnstitut Albert Prévost 
Since the beginning of December. I1nstitut 
Albert Prévost in Montreal has offered the 
Quebec population three new psychiatric 
services: a diagnostic center. a day-care 
center. and a center for disturbed adoles- 
cents. This new undertaking aims to permit 
easier access by the public to specialized psy- 
chiatric services. 
The diagnostic center permits centraliza- 
tion of all applications for care. Immediate 
consultation is available for patients who 
come to the center and appointments will 
be made within 24 hours for those who tele- 
phone. After a preliminary evaluation, 
patients can be directed to the appropriate 
services. The outpatient clinic will now be 
limited to treatment of ambulatory patients. 
The day-care center can accomodate 20 
persons. These come to the hospital several 
days each week from 9:00 A.M. to 4.00 
P. M. These patients are those who. follow- 
ing hospitalization. require a period of 
adaptation to life outside the institution. 
those who need medical supervision, or those 
who do not need continuous hospital treat- 
ment but who will benefit from institutional 
services on a day basis. Experiments in other 
centers have shown that hospitalization can 
be reduced and often avoided. Therapeutic 
techniques center around group therapy and 
activities. 


(Continued on page 14) 
THE CANADIAN NURSE 13 



Gynecologist's Claim Investigated 
An American gynecologist is being in- 
vestigated by the U.S. Food and Drug 
Administration, according to Canadian 
Doctor, for claiming that oral contracep- 
tives prevent menopause. 
Dr. Robert A. Wilson, of Brooklyn, 
New York, made the claim in his recently 
published book Feminine Forever. 
FDA spokesmen said the statement is 
being investigated to determine whether it 
extends beyond claims made for the con- 
traceptives on labeling approved by the 
Administration. 
An advisory committee which recently 


news 


(Continued from page 13) 


The center for dislUrbed adolescents pro- 
vides beds for 10 patients and is reserved 
for boys from 14 to 18 years. This service 
brings to 160 the number of beds for 
adolescents of both sexes in the Montreal 
region. The center is attached to the child 
psychiatry division. 
The outpatient clinic and the day-care 
center will eventually include adolescents of 
both sexes. 


ONE-STEP PREP 



 


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with 
FLEET ENEM
 
sÙzgle dose 
disposable unit 
FLEET ENEMA's Fast prep time obsoletes soap and 
water procedures. The enema does not require warm- 
ing. It can be used at room temperature. It avoids the 
ordeal of injecting large quantities of fluid into the 
bowel, and the possibility of water intoxication. 
The patient should preFerably be lying on the leFt side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. LeFt 
DIo.I.,&
 colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. IF a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
And afterwards, no scrubbing, no sterilisation, no 
preparation For re-use. The complete FLEET ENEMA 
unit is simply discarded! 
Every special plastic "squeeze-bottle" contains 4'h 
fl. oz. of precisely Formulated solution, so that the 
adult dose of 4 fl. oz. can be easily expelled. A patented 
diaphragm prevents leakage and reverse flow, as well 
as ensuring a comFortable rate of administration. 
Each J 00 cc. of FLEET ENEMA confains: 
Sodium biphosphate _ _ . 16 gm. 
Sodium phosphate . . . . . . . . . . .. 6 gm. 
For our brochure: "The Enema: Indicatians and Techniques", 
containing full information, write to: Professional Service 
Department, Charles E. Frosst & Co., P.O. Bax 247, 
Montreal 3, P.Q. 


j 
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A QUALITY PHARMACEUTICALS 
-."". C
E;.
6...Co. 

 .O'H;;:N
D IN CANADA IN ,::/
AD" 


14 THE CANADIAN NURSE 


completed a nice-month study of contra- 
ceptives reported no data indicating that 
any of the oral type are effective in altering 
the natural history of patients. 
An assistant to the FDA Commissioner 
said the issue is "a very involved legal 
question." 


Metabolic Research Ward 
Opens in Winnipeg 
Winnipeg Children's Hospital, Manitoba, 
opened a new ward for the diagnosis and 
treatment of metabolic disorders in children 
in mid-January, 1967. 
By coordinating the efforts of medica] 
and parameòical personnel, dietitians, bio- 
chemists, pharmacists, nurses, occupationaJ 
therapists, and social services, the metabolic 
ward will provide a complete range of 
services for both diagnosis and treatment of 
these disorders. I 
The unit will also offer services on an I 
outpatient basis, and conduct educational 
programs in the home management of meta- 
bolic disorders. 
The diagnosis of metabolic disorders is 
often delicate and painstaking and requires 
the young patients to undergo series of 
tests including careful measurement of die- I 
tary intake and excretions. Apparatus for 
collecting specimens from young children I 
plus storage facilities for these specimens I 
will be standard equipment in the new ward. 
Of the more than 100 metabolic disorden 
that have been diagnosed, some are tem. 
porary while others require a lifetime 01 
treatment. By opening its new ward, the 
Winnipeg Children's Hospital is joining the 
fight to lower the dea.th rate among childrel1 I 
suffering from such diseases. 
Mrs. Manfred Jager, appointed head 
nurse on the ward, prepared for her ne'" I 
position by inspecting metabolic wards ill 
Toronto, Boston, and Montreal. Mrs. Jager 
a graduate of the Winnipeg Children's Hos- 
pital, worked there as staff nurse and assis. 
tant evening supervisor, and assisted in esta- 
blishing a day hospital for children at the 
Mount Carmel Clinic in Winnipeg. 
The ward, to be located in the "four south 
section of the hospital," will be specially 
equipped with both the personnel and appa- 
ratus necessary to diagnose the disorders. 


No Gyn on Obs! 
New Jersey has stopped hospitals in that 
state from combining the care óf obstetric 
and gyneologic patients on the same nursing 
unit, according to an item in RN. 
The December issue of the nursing 
magazine reported that a three-year pilot 
study had been stopped by the state be- 
cause the hospitals involved in the research 
often violated the s!rict rules governing 
the admission of gyneologic patients to 
the maternity floors. "If pilot hospitals 
under close check ignore such criteria, 
other hospitals are even more likely to do 
so," said one state official. 
(Continued on page 16) 
FEBRUARY 1967 



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GO!... Where the ACTION is! 


. 
· Mrs. Helen Middleworth, Director, Nursing Service 
· Albany Medical Center Hospital 
. 
. Albany, New York 12208 


Albany Medical Center, that's where. A modern teaching hos- . 
pital perfectly located in beautiful upstate New York . . . on . 
the doorstep of New York City's bright lights . . . exciting . 
horse racing at Saratoga. . . summer homes of the Philadelphia · 
and Boston Symphony Orchestras. . . scenic lake George . .. · 
. 
and the greatest skiing in the East. . 
Our nursing opportunities are tops, too. For details, send for · 
our free booklet, "Albany Medical Center Nurse." · 
. 
. 
Albany Medical Center Hospital : 


Please send me a free copy of your nursing booklet. 


NAME ................. ...... ...... .,___. ...... 


ADDRESS _. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 


:E8RUARY 1967 


CITY ...............STATE ...........ZIP......


 
THE CANADIAN NURSE 15 



MOVING 


? 


. 


DON'T FORGET YOUR 
CHANGE OF ADDRESS 


Name: 


Registration No.: 
(If registered in two provinces, 
please give both.) 


Province: 


Old Address: 


New Address: 


Date effective: 


Allow at least six weeks 
for change of address 


Mail to: 


The Canadian Nurse 
50 the Driveway 
Ottawa 4, Onto 


16 THE CANADIAN NURSE 


news 


(Corzt;ll11ed from page /4) 


"Operation Hospital Supplies" 
Health Minister M. B. Dymond has an- 
nounced plans for Ontario's Department of 
Health to provide equipment for West Indies 
hospitals. The project will be known as 
"Operation Hospi
al Supplies." 
Dr. Dymond revealed that several weeks 
ago his Department had initiated a survey 
throughout general and psychiatric hos- 
pitals in Ontario to ascertain what surplus 
equipment is on hand for disposal. Corres- 
pondence with the Ministers of Health of the 
West Indies had previously revealed that 
most of the island hospitals lack many 
pieces of equipment that Canadians asso- 
ciate with a well-run hospital. 
"Early survey returns received from a 
few hospitals here in Ontario have been 
more than gratifying," stated Dr. Dymond. 
"I am confident Operation Hospital Supplies 
wi1l prove to be a highly successful project 
and most helpful to the people of the Carib- 
bean. I feel aU Canadians can share a 
sense of pride in the knowledge that a 
Centennial project of this nature will add 
to the health and well-being of their less 
fortunate Commonwealth partners," he ad- 
ded. 
Equipment such as beds, bedpans, tables, 
trays, kidney basins is being requested. All 
Ontario hospitals, including their medical 
and nursing staffs have been invited to sup- 
port Operation Hospital Supplies throughout 
1967. 


RNAO Recommends Change 
In Public Health Act 
An amendment to Ontario's Public 
Health Act was one of the recommenda- 
tions submitted by the Registered Nurses' 
Association of Ontario to the provincial 
government's Committee on the Healing 
Arts last December. 
RNAO recommended "that the Public 
Health Act be amended to ensure that 
nursing service prQvided by public health 
nurses be an integral part of any public 
health unit." The present Act allows a 
public health unit to function with the 
provision of nursing services to the com- 
munity. This, in effect, means that the 
community is not guaranteed the services 
of public health nurses. 
In addition to denying the community 
of nursing services, this omission in the 
Act has another ramification, according 
to the RNAO brief. "There are implica- 
tions for public health nurses who might 
wish to become involved in negotiating 
with their employer, as it is quite within 
his rights to discontinue public health nur- 
sing services without closing down the 
unit." 


ICN Council of International 
Representatives to Meet in July 
The Board of Directors of the Interna- 
tional Council of Nurses discussed the 
tentative agenda for the meeting of the 
Council of National Representatives to be 
held June 26 to July 1, 1967 at Evian, 
France. The agenda includes suggested 
plans for the next ICN Quadrennial Con- 
gress to be held in Montreal in July, 1969. 
The executive director and the president 
of the Canadian Nurses' Association will 
attend on behalf of Canada. The other 63 
member countries are expected to send 
representatives also. 
At this meeting the theme for the 1969 
Congress will be chosen. Seventeen national 
member associations, including Canada, have 
submitted suggested themes. The subjects 
reflect the wide concern of the associations 
for the adaptation of nursing to the tech- 
nological age and their interest in nursing 
research and nursing administration. 


Pharmaceutical Firm Expands 
Construction of a new wing is well under 
way at The British Drug Houses (Canada) 
Ltd., and the building is scheduled for 
completion in early 1967. Twelve thousand 
square feet on two floors are being added 
to the existing plant in surburban Toronto, 
at a cost of $750,000. 
The increased laboratory facilities will 
enable BDH to play an even greater part in 
research and development of medical pro- 
ducts, laboratory chemicals and general 
chemicals, according to Mr. F. Burke. 
managing director of the company. 


Winners Fly to 
Easter Island 
A jet trip to Easter Island is in the im- I 
mediate future for Mr. and Mrs. G.H' I 
Pimm of 251 Park Road, Rockcliffe, Ot- 
tawa. Mr. Pimm is the winner of the Easter 
Island contest mentioned in the August 
1965 issue of THE CANADIAN NURSE. 
Purpose of the contest was to raise mone) 
to pay for trailers left on Easter Island b) 
the Canadian Medical Expedition. 
In an article "Aku-Aku And Medicine 
Men" (August 1965), Carlotta Hacker. 
staff member of the expedition, explained 
how the trailers were left. During a two- 
month medical survey conducted on the 
island by Dr. Skoryna, the 37 team mem- 
bers lived and worked in ACTA trailers 
which they donated to the Pascuenses on 
their departure "as a much-needed annex 
to the hospital and as a permanent biologi- 
cal station." 
Following the article, a contest was an- 
nounced to help pay for the trailers. B) 
becoming an Associate of the Easter Island 
Expedition Society at the cost of $1.00, 
one became eligible for a free trip to 
Easter Island. 
Mr. Pimm and his wife, winners of the 
contest, will fly to the Island via Chile, by 
Canadian Pacific Airways. 
FEBRUARY 1967 



I 

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FEBRUARY 1967 


o 


'I 
I 
ç 


When the 
call is for IIStat." 
diagnostic findings 


. . . you can rely on AMES tests for immediate 
results in which you can have the utmost 
confidence. For example: 


LABSTIX. Reagent Strips: provide the broadest urine 
screening possible from a single reagent strip test; you get 
5 basic uro-analytical facts in 30 seconds-pH; protein; 
glucose; ketones (acetone and acetoacetic acid), and occult 
blood. The new firm, clear, plastic reagent strip permits 
precise, reproducible readings in all 5 diagnostic areas. 


DEXTROSTIX. Reagent Strips: provide a blood glucose 
determination in just 60 seconds with only one drop of 
capillary blood. DEXTROSTIX is invaluable in diabetic 
screening and management, and in emergency situations 
such as differential diagnosis of diabetic coma. This 
"true-glucose" method is also useful in a variety of clinical 
situations where rapid and accurate blood glucose 
estimations are needed. 


CliNITEST. Reagent Tablets-provide a quick, reliable, 
quantitative estimate of urine sugar. Testing with 
CLiNITEST has special significance for the hard-to-control 
diabetic, the newly diagnosed patient. or in diabetes when 
insulin, other medication or diet is being adjusted. 


Reliable Reproducible Results 
AMES tests are easy to perform and require no elaborate 
laboratory apparatus. They are designed to provide depend- 
able clues to abnormal conditions when rapid findings are 
necessary. Reagents employed in each strip are precisely 
controlled to provide uniformity in composition. Accurate, 
reliable reproducible readings are thus assured. Ready inter- 
pretation of results is permitted through the precise matching 
of colour changes observed after testing, with colour charts 
provided for each determination. AMES diagnostic aids save 
time, money and space. Moreover they prove of material 
assistance to physicians by helping to recognize patients 
who need immediate care, further study, or more extensive 
diagnostic procedures. 


Ames Company of Canada. ltd. 
Rexdale, Ontario. 


fA' 


AIVIES 


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CAM-OJ366 


THE CANADIAN NURSE 17 



names 


o n J a n u a r y 2, 

 1967, Tatiana La be- 
koYSki wilJ take up 
her duties as the first 
director of the new 
Cornwall Regional 
School of Nursing. 
Although the class- 
rooms and residence 
of the new school 
are not yet under construction, Mrs. Labe- 
kovski's appointment will mean "the begin- 
ning of a concentrated effort to get things 
ready for the new class," for September, 
1967. 
Mrs. Labekovski received her B.A. in 
philosophy and philology from the Uni- 
versity of Belgrade, Yugoslavia, and con- 
tinued on toward a medical degree until her 
studies were interrupted by World War H. 
After her arrival in Canada, she grad- 
uated from St. Joseph's School of Nursing 
at Hotel Dieu Hospital, Cornwall, obtained 
her diploma in nursing education from 
Queen's University, and was a member 
of the teaching faculty at the Cornwall 
school of nursing for six years. 
In the past four years, Mrs. Labekovski 
has been assistant secretary, nursing edu- 
ootion and service at the Toronto head of- 
fice of the Registered Nurses' Association 
of Ontario. 
Mrs. Labekovski arrived in Cornwall 
late this December to "settle in before 
starting to work on her rather monumental 
task." 
All inquiries about the new school should 
be directed to the schools of nursing at 
either of the local hospitals. They will be 
collected and held there until Mrs. Labe- 
kovski has set up her office procedures. 


At the end of November 1966, the 
Canadian Nurses' Association in Ottawa 
welcomed two interesting visitors - Miriam 
M. Hornsby-Odoi and Ah Foo Chong - 
both on World Health Organization fellow- 
ships. 
Mrs. Hornsby-Odoi, a native of Ghana, 
was awarded a six-month fellowship com- 
mencing November 14, 1966, to study 
public health nursing administration in 
Canada and the United States. 
Since 1963 she has been principal public 
health nurse with the ministry of health 
in Accra, Ghana. 
Following her study, Mrs. Hornsby-Odoi 
plans to introduce and apply new practical 
ideas to improve the organization of public 
18 THE CANADIAN NURSE 


health nursing service in Ghana. 
Miss Ah Foo Chong, whose six-month 
award began January 3, 1967, is studying 
public health nursing administration at the 
University of California and in San Fran- 
cisco, Minnesota, New York, Washington, 
Baltimore, and Canada. 
Since 1963 Miss Ah Foo Chong has 
served with the Ministry of Health, Kuala 
Lumpur, Malaya as principal matron. In 
this position she has administrative duties 
at national level and is responsible to the 
director of medical services for the develop- 
ment and expansion of the health and 
medical nursing service and nursing train- 
ing programs. 
The fellowship wilJ provide "an op- 
portunity to work with nurses who are res- 
ponsible for the administration of public 
health nursing programs at the national, 
state, and local levels in the U.S. and Ca- 
nada." On her return home, Miss Ah Foo 
Chong wilJ be in a position to apply "new 
ideas in the development of these services, 
and to analyze the existing public health 
nursing services." 


-, 
- .. 


Ramona Paplaul- 
kal-Ramunal, a na- 
tive of Lithuania, has 
recently joined the 
editorial staff of 
L'INFIRMIÈRE CANA- 
DlENNE. 


Miss Paplauslcas- 

 Ramunas attended the 
University of Ottawa 
where she obtained her B.A. and B.Sc. in 
1961. After graduation, she gained five 
years' experience as a publications editor 
with the Canadian Department of Agri- 
culture. 
A member of various organizations, Miss 
Paplauskas-Ramunas has also held executive 
positions with the Ottawa Citizenship Coun- 
cil, Canadian Industrial Editors' Associa- 
tion, and the Professional Institute of the 
Public Service of Canada. 



 


Recently appointed 
to the newly esta- 
blished position of 
nursing advisor in 
public health psy- 
chiatry for The On- 
tario Hospital, King- 
ston, was Helen Eliza- 
beth Etherington. 
A graduate of the 



 
I", . 
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 _- 


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... 


Mack Training School, St. Catharines, 
Ontario, Miss Etherington has also received 
postgraduate education in both public health 
nursing and administration and supervision 
in public health nursing from the Univer- 
sity of Toronto. In 1963-64 she attended 
the McGilJ School for Graduate Nurses 
where she obtained a diploma in teaching 
and supervision in public health nursing 
with a major in psychiatric nursing. 
Her experience has included two years 
as a faculty member at The Ontario Hos- 
pital School of Nursing, Kingston, and 
seven years in various public health nursing 
positions including that of supervisor of 
public health nursing with the department 
of health, Peterborough. 


Helen Jean Hanel, 
a 1953 graduate of the 
school of nursing at 
the Calgary General 
Hospital, recently as- 
sumed her new posi- 
tion as director of 
nursing at the Nanai- 
mo Regional General 
Hospital, Nanaimo, 


British Columbia. 
Prior to her new appointment, Mrs. 
Hanel worked at the Royal Inland Hospital, 
in Kamloops, B.C. as associate director of 
nursing services. Other experience includes 
two and one-half years as director of nur- 
sing at the Union Hospital, Canora, Sas- 
katchewan, and service as a general duty 
nurse in St. Paul's Hospital, Saskatoon, 
and the Union Hospital, Swift Current, 
Saskatchewan. 


Ena Maud Orr, 
director of nursing 
of the Ontario Hos- 
pital, Brockville, On- 
tario, for the past 35 
years, retired Decem- 
ber 31, 1966. 
Mrs. Orr graduat- 
ed from the Ontario 
Hospital School of 
Nursing, Toronto. In 1930 she was among 
the second class to graduate in nursing 
education from the University of Toronto. 
Before assuming her duties as director 
of nursing in Brockville, she was an in- 
structor at the Ontario Hospital, Toronto. 
Almost 400 nurses have graduated from 
the school of nursing "which she shaped 
and kept vigorous through the many 
changes in nursing education." 


n 


. 


FEBRUARY 1967 



Barabara Ellemer. 
has been appointed 
assistant superinten- 
dent of nursing educ- 
ation for the Saskat- 
chewan Department 
of Education. 
A 1958 graduate 
of the school of nur- 
sing of the Regina 
:Jeneral Hospital, Mrs. Ellemers also ob- 
ained a diploma in public health nursing 
'rom the University of Saskatchewan, a 
B.N. from McGill, and is presently work- 
ng toward her M.A. at the University of 
)askatchewan. 



. 


Prior to her present appointment, Mrs. 
Ellemers served with the Victorian Order 
Jf Nurses, the Saskatchewan Department 
Jf Public Health, and the Regina City 
Health Department. She also worked at 
the Jewish General Hospital in Montreal 
in 1962-63 as an instructor and during the 
following year as a lecturer at the McGill 
University School for Graduate Nurses. 


Valerie O'Connor, former editor of the 
International Nursing Review, recently be- 
came the new editor of Hospital World. 
Miss O'Connor, awarded the Gilchrist 
Scholarship to study in Great Britain in 
1961, was the first Australian nurse to 
undertake an academic course in journalism. 
On completion of her studies at the Regent 
Street Polytechnic School of Journalism, 
she joined the editorial staff of Nursing 
Mirror. Subsequently she went to the Inter- 
national Council of Nurses as public rela- 
tions officer and editor of the Council's 
publication. 


Lelia Raymond of the United Kingdom, 
has been appointed acting editor of the 
International Nursing Review. Until recent- 
ly, Miss Raymond was clinical instructor 
at King's College Hospital, London, Eng- 
land. 
She undertook her basic nursing educa- 
tion at King's College Hospital; her post- 
basic nursing education includes a certifi- 
cate for clinical instructor and teacher. 
She has been joint editor of the King's 
College Hospital Nurses League Journal, 
which appears annually. 


W.S. Hacon, former chief of the Emergen- 
cy Health Services Division for the Depart- 
ment of National Health and Welfare, reli- 
quinshed his appointment recently to accept 
a new position with the department. 
Mr. Hacon is the new director of Health 
Resources in the Department of National 
Health and Welfare. 
His successor in the Emergency Health 
Services has yet to be appointed. 
FEBRUARY 1967 


Georg Feilotter, for- 
mer instructor at the 
Cornwall General 
Hospital School of 
Nursing, is the newly 
appointed assistant di- 
rector of nursing (ser- 
vice) at the hospital. 
I 
 Mr. Feilotter gra- 
duated as a nurse in 1954 in his native 
Gennany, and emigrated to Canada in 
1960. His first Canadian appointment was 
at the Victoria General Hospital in Win- 
nipeg where he worked in medical-surgical 
nursing. From 1962 to 1964 he was a head 
nurse at the newly built Rehabilitation 
Centre in Winnipeg. 
Mr. Feilotter next attended the Univer- 
sity of Ottawa where he obtained two 
diplomas, one in rehabilitation nursing and 
the other in teaching and administration. 
He is presently doing part-time study lead- 
ing to his B.Sc.N. 


Mildred Irene Walker. who retired Novem- 
ber 30, 1966 as senior nursing consultant in 
the occupational health division of the 
Department of National Health and Welfare 
(THE CANADIAN NURSE, January, 1967) died 
in hospital on January 16. 
Miss Walker began her nursing career in 
1924 with her graduation from the Victoria 
Hospital School of Nursing, London, On- 
tario. Her busy career was largely adminis- 
trative and included experience as a lecturer, 
assistant professor, and public health nurse. 
Miss Walker became senior nursing consul- 
tant in 1949, a position she maintained until 
her retirement last November. 


"A gifted Ontario woman," and a great 
Canadian nurse, Edith MacPherson Dickson, 
died recently after a long and active life. 
The number of highlights in her profes- 
sional career indicate the major role she 
played on the Canadian nursing scene. 
After graduating from the Toronto Gen- 
eral Hospital School of Nursing, where she 
was noted "as being a leader" by Mary 
Agnes Snively, founder of the Canadian 
Nurses' Association, Miss Dickson went to 
Weston as superintendent of nurses for the 
Toronto Tuberculosis Hospital. 
During the fonnative years of 1920-22 
Miss Dickson served a tenn as president of 
CNA. She was also the driving force that 
led to the passing of the Ontario Registration 
Act. 
One of the first three recipients of the 
Mary Agnes Snively Medal for outstanding 
accomplishments in nursing in Canada, Miss 
Dickson was also awarded an honorary life 
membership in CNA in 1958. 
Her many activities included membership 
on the committee to erect a national memo- 
rial in the Hall of Fame, Parliament Build- 
ings, Ottawa, in honor of nurses who lost 
their lives in the First World War. 



 


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Try the Mt. Sinai Hos- 
pital of Cleveland which 
offers $500 a month be- 
ginning salaries, educa- 
tional opportunities, and 
job satisfaction - all in 
the cultural center 'of the 
city. Write to Nurse Re- 
cruiter, Dept. CA for more 
information. 



 THE MOUNT SINAI 
HOSPITAL OF CLEVELAND 
Uninrsiry Cirde . Clevellnd, O.io 4-4106 


THE CANADIAN NURSE 19 



Save hours of your time D 1 1 @ 
by replacing the enema with... U CO ax Suppositories 


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Even modern enema equipment is cumbersome and time-. 
consuming to assemble. Irrigation poles, bags, tubing, 
bedpans-all must be drawn from Central Supply, in- 
spected and brought to the bedside. It cuts into your valu- 
able morning time and becomes a real burden when you 
have several patients needing enemas. 
And, more often than not, your patients are distressed at 
the prospect of discomfort and loss of dignity-especially 
the elderly, the seriously ill, or postpartum and post- 
surgical patients. 


Dulcolax (brand of bisacodyl) 
Dulcolax Suppositories 10 mg 
Dulcolax Suppositories for Children 5 mg 
Dulcolax Tablets 5 mg 


" 


Dulcolax Suppositories offer a sure, simple way to elimi- 
nate the enema routine. One small suppository is inserted 
in seconds. You like the simplicity and convenience- 
patients are grateful to be spared the ordeal of an enema. 
Dulcolax Suppositories usually act in 15 minutes to I hour, 
so you can time evacuations and reduce accidents. You 
can finish the whole ward in less time, with Jess effort, 
less soiled linen. 


Boehringer Ingelheim Products 
Division of Geigy (Canada) Limited, Montreal 


8-S 113-6S 



dates 


February 9-10, 1967 
Meeting of Standing Committee on 
Nursing Education, CNA House, 
Ottowa. 


End of March 
Institutes for Instructors 
Ramada Inn, Vancouver, B.C. 
A two-day institute sponsored by the 
Registered Nurses' Association of B.C. 


March 19 and 22, 1967 
Deportment of Notional Health and 
Welfare, Notional maternal and 
Child health conference. 
Talisman M.otor Hotel, Ottowa. 
Inquiries: Dr. Jean Webb, Chief. 
Child and Maternal Health Division, 
Deportment of Notional Health and 
Welfare. Brooke Claxton Building, 
Ottowa 3, Ontario. 


April 28, 1967 
Nurses' institute on respiratory 
disease, Notional Museum, Otta
a. 
For information write The Canadian 
Tuberculosis Association, 343 
O'Connor Street, Ottowa 4. 


May 4-6, 1967 
St. Boniface Hospital, School of 
Nursing, 25th Reunion of the 1942 
graduating closs. 
Would members of the 1942 
graduating closs please write to Miss 
F.E. Taylor. R.N., 10123-122 Street. 
Edmonton. 


May 8-12, 1967 
Notional League for Nursing, Biennial 
Convention. Theme: "Nursing in the 
Health Revolution." 
New York Hilton Hotel, New York City. 


May 10-12, 1967 
Canadian Hospital Association, 
Montreal. P.Q. 


May 15, 1967 
Notional Nursing Day. 


May 16-19, 1967 
Alberto Association of Registered 
Nurses Annual Meeting. 
Chateau Lac:>>mbe, Edmonton, Alberto. 


May 24-26, 1967 
International symposium on electrical 
activity of the heart. 
London. Ontario. 
For further information, write to 
Dr. G.W. Manning, Victoria Hospital, 
London. Onto 
FEBRUARY 1967 


May 29-31, 1967 
Operating Room Nurses' Fourth 
Ontario conference. 
The Inn on the Pork, Toronto, Ontario. 
Sponsored by the Operating Room 
Nurses of Greater Toronto. 
Direct inquiries to: Mrs. Eleanor 
Conlin, R.N., 437 Glen Pork Avenue. 
Apt. 309. Toronto 19. Ontario. 
May 31-June 2, 1967 
Registered Nurses' Association of 
Novo Scotia Annual Meeting. Sydney. 
N.S. 


May 31-June 2, 1967 
Registered Nurses' Association of 
British Columbia Annual Meeting 
Bayshore Inn, Vancouver, B.C. 


June 5-8, 1967 
Atlantic Provinces Hospital Association, 
Annual Meeting. 
June 12-15, 1967 
Canadian Dietetic Association 32nd 
Convention 
Chateau Laurier, Ottowa. 


June 18-21, 1967 
Ottowa Civic Hospital, Centennial 
Home Coming. 
Alumnae of former associates of the 
Ottowa Civic Hospital who are 
interested in the program should 
write to: Executive Director, Ottowa 
Civic Hospital. 
June 18-23, 1967 
Canadian Medical Association, 
100th annual meeting, M.ontreal, 
Quebec. 
Address enquiries to Dr. A.D. Kelly, 
Executive Secretory. 150 St. George 
St., Toronto 5, Ontario. 


June 24, 1967 
St. Joseph's Hospital School of 
Nursing, Toronto, Centennial Reunion. 
Any graduates who do not receive 
alumnae newsletters. please send 
nome and address to: St. Joseph's 
Hospital School of Nursing Alumnae. 
30 The Queensway, Toronto 3, 
Ontario. 


July, 1967 
75th Anniversary, Novo Scotia 
Hospital School of Nursing. 
Dartmouth. N.S. 
All interested graduates please 
contact Mrs. G. Varheff, 
20 Ellenvale Ave., 
Dartmouth, N.S. 


NEW FOR HOSPITALS 


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lope are completely sterilized by 
the Autoclave, the indicator ink 
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Autolope is security folded and 
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th .the 
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THE CANADIAN NURSE 21 



A nursing career with a difference. 


Excellent career opportunities exist 
for graduate nurses in the Canadian 
Forces Medical Service. Applica- 
tions will also be accepted from 
nursing s tuden ts in their final 
year of training. And enrolment 
will proceed upon registration. 
The duties of a Canadian Forces 
Nursing Sister are two-fold; that of 
a professional nurse and that of a 
commissioned officer. Her employ- 
ment therefore .. J carries with it 
the respon- 
 
 'sibilities of 
leadership as . 
 well as those 
of the medical \ '1 profession. 
It also carries with it op- 
P 0 r tun i tie s l' to travel, to 
serve in Canadian 
l military es- 
tablishments all across Canada 
and in Europe. 


The starting salary is $540.00 a 
mon th, and increases in pay are 
granted every three years. 30 days 
annual holiday, and free medical 
and dental care are added benefits. 
Nursing in the Canadian Forces 
Medical Service offers valuable and 
varied experience in different en- 
vironments, opportunities for pro- 
fessional advancement, the excite- 
ment of travel at home and over- 
seas, a respected position, and a 
unique way of life not usually 
available to a Registered Nurse. 
Further information and appli- 
cations for enrolment may be ob- 
tained from your nearest Canadian 
Forces Recruiting Centre, or by 
mailing the attached coupon. 


The Canadian Forces. 
Give it some thought. 
r-----------------------, 


Director of Recruiting, 
Canadian Forces Headquarters, 
Ottawa 4, Ontario 


Nam .. 


Addres " 


City or Town, and Provinc .. 


L_______________________
 


22 THE CANADIAN NURSE 


FEBRUARY 1967 



in a capsule 


Drugs from the Depths 1 
The underwater life of Australia's Great 
Barrier Reef may be a potential source of 
new therapeutic agents, according to Dr. 
Robert Endean of the University of Queens- 
land. 
Working with a six-man team, Dr. Endean 
has isolated from one variety of cone shell 
a toxin that produces muscular relaxation. 
This toxin affects only skeletal muscles, and 
does not appear to produce any of the side 
effects associated with curare type of drugs. 
Another variety of cone shell has yielded 
a toxin that cause
 sustained contraction 
of muscle. Dr. Endean reports, "I know 
of no other substance in the world which 
can achieve this effect, and it may prove 
to be valuable as a heart stimulant. We 
have already successfully tried it on the 
heart muscle of the toad." - The Horner 
Newsletter. 


"Pure" Doctors 
A selection of nurses' examination mis- 
takes, compiled by Roger Brook, has been 
published by the Souvenir Press, London, 
under the title "And after that Nurse?" The 
following excerpts show just how important 
wording can be. . . 
A cross infection committee was set up 
in the hospital to deal with affection be- 
tween nurses and patients. 
Phenobarbitone. may be given to seduce 
the patient and put his mind at rest. 
Cross infection is always blamed on 
nurses, but the real bugbears in this respect 
are the doctors who think they are too 
pure to carry such things as germs. - 
Nursing Mirror, 122: 599, Sept. 23, 1966. 


The Nose Knows 
One of the most disagreeable factors in 
working with geriatric patients, particularly 
those who are incontinent, is urinary odor 
which frequently permeates the entire en- 
vironment where patients are housed. A 
report in a medical journal stating that 
cranberry juice was used to deodorize 
wards having incontinent patients, prompted 
Charles R. Du Gan and Paul. S. Carda- 
ciotto to conduct an experiment in two 
geriatric wards, one containing 110 male, 
the other 110 female patients. 
During the program the usual methods of 
deodorization were discontinued and odor 
levels were obtained chemically as well as 
noted subjectively by personnel. 
The doses of cranberry juice were gra- 
dually increased from three ounces per pa- 
tient per day to a maximum of six ounces 
daily. The chemical tests on the urine and 
FEBRUARY 1967 


air reflected little change in either male or 
female wards after the administration of 
cranberry juice was begun. 
The personnel, using their noses as guides, 
reported more significant impressions. After 
the first week of giving cranberry juice, 
personnel noted that the odors were less 
evident in the wards. As the dose was 
increased, the odors became markedly re- 
duced. It was also reported by the ward 
personnel that the patients who had com- 
plained of a burning sensation on urination 
no longer complained of discomfort. Those 
incontinent patients who had had a strong 
odor about them seemingly had less odor 
when receiving cranberry juice regularly. 
The urine odor on clothing and bed linen 
was reduced markedly. 
During the administration of the cran- 
berry . juice, no untoward reactions were 
noted in any of the patients. - Excerpts 
from Journal of Psychiatric Nursing, Sept- 
ember, 1966. 


Beautiful Eyes 
Communication between adults has be- 
come a highly sophisticated art, with the 
result that true feelings are often lost be- 
neath a protective covering of words. It is 
a lack of such sophistication that makes 
the speech of mentally retarded adults 
childlike in quality. What we mistake for 
stupidity in the conversation of retarded 
adults is often a frankness and direct sim- 
plicity so often absent in our more technical 
manipulation with words. 
Jerome Nitzberg, M.S.W., in the Sept. 
issue of Canada's Mental Health, cites a 
few examples of the disarming - if not 
always rational - formulations of the re- 
tarded. One young man with a talent for 
leaving the floor dirty after mopping it, 
sincerely explained that "the floor is too 
big and the mop is too small." Another 32- 
year old childishly explained why he ne- 
glected to bathe more often: "I'll only get 
dirty again!" A young woman, in explaining 
why she wept so frequently, commented, 
"My eyes are beautiful when they are full 
of tears." 


Employee Services Recognized 
The presentation of long service awards 
is well established in industry, but equally 
industrious hospital employees often go 
unrecognized. That is until recently, when 
the Brockville General Hospital in Brock- 
vme, Ontario, set a precedent by awarding 
31 long service awards to personnel em- 
ployed there for more than 10 years. 


The director of nursing, Vera J. Preston, 
proved to have the longest service of all - 
over 25 years. Miss Preston, who began 
employment with the hospital on March 1, 
1938, received the top award of a gold 
watch as well as a gold service pin for 
"faithful devotion to her duties." 
Miss Nora Towe, of the food service 
department, received a 20-year gold service 
pin, and Miss Gladys Edwards, supervisor 
of the central supply department, who is 
only a few months short of 15 years service, 
received a 10-year service pin. Other nurses 
with 10 years and more service were: Miss A 
Foster, Mrs. S. Willows, and Miss Joan 
Freeman. 
All departments of the hospital were 
represented, including housekeeping, engi- 
neering, administration, and food service. 


Burnt Cakes and Car Accidents 
Insurance companies take note! From the 
results of her "Experimental Study of Home 
Accident Behavior," Dr. Joan Guilford, 
director of the American Institutes of 
Research in Los Angeles, concludes that 
"one might speculate that a woman drives as 
she keeps house." The frequency of accidents 
in the kitchen appears to be related to the 
frequency of those on the highway and to 
vehicle code violations, a study of auto- 
accident and violation records of 178 women 
indicated. Further, the type of auto accident 
- personal injury or property damage - 
seems selectively related to those in the 
kitchen. 
Dr. Guilford, who conducted the experi- 
ment using a mobile van with simulated 
home kitchen and one-way observation 
rooms, found that not only were home acci- 
dents correlated with auto accidents and 
traffic violations, but also that other factors 
- the number of a woman's children, her 
drinking habits, weight, personality traits 
and blood pressure - were related in many 
cases to accidents or near accidents. 
What factors may "predict" kitchen (and 
possibly automobile) accidents? One of the 
best, most consistent indications - at least 
in this study - was the number of children 
each subject had. "It seems clear that those 
subjects with more children have the lower 
accident rates," said Dr. Guilford. 
Other results indicated that when com- 
pared to teetotalers, women who drank al- 
coholic beverages were less likely to have 
kitchen accidents. Emotionally unstable 
women tended to have more personal-injury 
accidents, but not property damage. Both 
thin and obese subjects had more accidents 
than did average-weight subjects. 
THE CANADIAN NURSE 23 




 
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contents 


Introduction 
Body Fluid, Our Heritage from the Sea 
Cellular and Extracellular Fluid: Secretions and 
Excretions 
Units of Measure 
Gains and Losses of Water and Electrolytes 
Volume Changes in Extracellular Fluid 
Composition Changes of Major Extracellular 
Electrolytes 
Position Changes of Water and Electrolytes of 
Extracellular Fluid 
The Role of Nursing Observations in the Diagnosis 
of Body Fluid Disturbances 
The Elements of Nutrition 
The Nurse's Role in Preventing Imbalances of Water. 
Electrolytes, and Other Nutrients 
Help from the Lab 
Gauges for Dosage 
The Treatment of Body Fluid Disturbances 
Parenteral Fluid Administration - Nursing 
Implications 
Fluid Balance in the Surgical Patient 
Fluid Balance in the Badly Burned Patient 
Fluid Balance in the Patient with Digestive Tract Disease 
Fluid Balance in the Patient with Urological Disease 
Fluid Balance in the Patient with Cardiac Disease 
Fluid Balance in the Patient with Endocrine Disease 
Fluid Balance in the Patient with Neurologic Disease 
Fluid Balance in the Patient with Respiratory Disease 
Water and Electrolyte Disturbances from Heat 
Exposure 
Fluid Balance Disturbances in Infants and Children 
Bibliography 
Index 


To help save lives! 


A new and vitally important book 
on the nurse's role in prevention 
of body fluid disturbances. 


NURSES'HANDBDDK 
OF FLUID BALANCE 


Medical science recognizes that body fluid disturbances represent 
the common denominator of a host of illnesses; that every patient 
is a candidate for one or more of these disturbances; and that the 
life of a patient may depend upon early recognition, interpretation 
and intervention. Since the early recognition of fluid imbalance 
depends upon close observation of the patient, the nurse carries 
a heavy responsibility. She must be alert to adverse signs in the patient's 
progress and must understand their significance. 
Eminently qualified, the authors write with an insight into the 
medical problems and nursing needs of patients with fluid imbalance 
and provide the nurse - student and graduate alike - with a well- 
illustrated, comprehensive and illuminating book on body fluid 
disturbances. Emphasis throughout is on knowing what to look for 
- how to look for it - and what to do about it. - The authors 
first present general information concerning body fluid disturbances 
- their nature, pathogenesis, clinical manifestations and diagnosis. 
They then deal with the important clinical areas. 


By Norma Milligan Metheny, R.N., M.S., Department of Nursing, 
St. Louis Junior College, St. Louis, Missouri: formerly Medical-Surgical 
Coordinator, Missouri Baptist Hospital School of Nursing, St. Louis. 


William D. Snively, Jr., M.D., Clinical Professor in the Department oj 
Pediatrics, Medical College oj Alabama; Vice President, Medical AI/airs, 
Mead Johnson & Company: formerly Chairman, Fluid Balance Exhibit 
Committee, American Medical Association. 


275 PAGES 


90 ILLUSTRATIONS 


1967 


$7.50 


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J. B. LIPPINCOTT COMPANY OF CANADA LTD., 60 Front Street West, Toronto 1. 


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FEBRUARY 1967 


24 THE CANADIAN NURSE 


o Payment enclosed 
o Charge 


CN 267 



new products 


{ 


Descriptions are based on information 
supplied by the manufacturer and are 
provided only aø a service to readers. 


Pregslide 
(BELL-CRAIG) 
Description - A simple, inexpensive, 
and highly accurate urine test for preg- 
nancy. The Pregslide kit gives results in two 
minutes with an accuracy of 97%. Because 
of its high sensitivity, the new test can 
detect pregnancy earlier than any other 
slide test. 
Procedure - To perform the test, two 
prepared reagents are mixed with a single 
drop of the patient's urine on a specially 
tinted blue slide. The mixture will assume 
a smooth and, finally, a granular pattern if 
the patient is pregnant. In a negative test, 
.agglutination (clumping) will be visible 
within two minutes. 
For information on the new pregslide 
kit contact Bell-Craig Pharmaceuticals, 45 I 
Alliance Ave., Toronto 9, Ont. 


Showplace 
(BREWSTER) 
Description - This portable, table-top 
exhibition panel unit is offered in a variety 
of panel surfaces for use in hospital lob- 
bies, for fund raising or general public 
relations displays, and in nursing schools 
for instructional exhibits. 
The 25 lb. Showplace unit provides 24 
square feet of exhibit space in two 24" x 
36", two-sided panels encased in hard- 
.l\Vood frames. The equipment comes com- 
pletely assembled. 


\ 
4. 


I 

'II 
II 


.p. \ 


1
4I - 


The panel surfaces includes: 
 " thick 
"doeskin" Homasote, V<I" thick pegboard, 
'h" thick burlap-covered Homasote or V<I" 
thick burlap-covered pegboard. Frames are 
finished in walnut or driftwood. 
The Homasote panels will accept picture 
hoofs, nails, staples, pins and tacks, while 
the pegboard versions take print clips, 
hooks and shelves supplied by the manu- 
facturer. 
For further information, contact: The 
Brewster Corporation, Old Lyme, Conn. 
06371. 
FEBRUARY 1967 



 


Urecholine 
(MERCK, SHARP AND DOHME) 
Description - A new dosage size (25 mg. 
tablet) for Urecholine chloride has been 
added to the existing 5 and 10 mg. tablet 
size and the 5 mg.l cc. injection form. 
Urecholine chloride (bethanechol chlor- 
ide) is a parasympathomimetic agent that 
increases the smooth muscle tone of the 
gastrointestinal and urinary tracts. 
Indications - Urecholine chloride is 
recommended in the treatment of certain 
cases of postoperative urinary retention 
and atony of the bladder, postpartum uri- 
nary retention, postoperative abdominal 
distention, and in congenital megacolon 
when drug therapy is indicated. 
Dosage - Dosage and route of admin- 
istration must be individualized, depending 
on the type and severity of the condition 
to be treated. Mild and moderate disorders 
often respond to the tablet. Subcutaneous 
injection should be reserved for patients 
who do not respond to oral therapy. 
Oral: The usual adult dosage is 10 to 
30 mg. three or four times a day. Satis- 
factory response often follows 10 to 15 mg. 
The minimum effective dose is determined 
by giving 5 or 10 mg. initially and repeat- 
ing the same amount at hourly intervals 
to a maximum of 30 mg. until a satisfac- 
tory response occurs. The effects of the 
drug sometimes appear within 30 minutes 
and usually within 60 to 90 minutes. They 
persists for about an hour. 
Subcutaneous: The usual dose is 1 cc. 
(5 mg.), although some patients respond 
satisfactorily to as little as 0.5 cc. (2.5 mg.). 
The minimum effective dose is determined 
by injecting 0.5 cc. (2.5 mg.) initially 
and repeating the same amount at 15 to 
30 minute intervals to a maximum of four 
doses until satisfactory response is obtained, 
unless disturbing side effects appear. The 
minimum effective dose may be repeated 
thereafter three or four times a day as 
required. 
Injection Urecholine chloride is for sub- 
cutaneous use only. It should never be 
given intramuscularly or intravenously, 
since violent symptoms of cholinergic over- 
stimulation are likely to occur. Atropine 
is a specific antidote. A syringe containing 
a dose for adults of 0.6 mg. (1/100 grain) 
or more of atropine sulfate should always 
be available to treat symptoms of toxi- 
city. 
Contraindications - Urecholine chloride 
is contraindicated in hyperthyroidism, preg- 
nancy, peptic ulcer, latent or active bron- 
chial asthma, pronounced bradycardia or 


hypotension, vasomotor instability, coron- 
ary artery disease, epilepsy and parkin- 
sonism. 
Side Effects - Subcutaneous doses of 
I cc. or less may cause such mild side 
effects as abdominal discomfort, salivation, 
flushing of the skin or sweating. 
For further information or to receive 
the Urecholine file booklet, contact: Merck, 
Sharp and Dohme, P.O. Box 899, Mon- 
treal 3, P.Q. 


Literature Available 
Patterns of Disease, a booklet published 
six times yearly by Parke, Davis and Comp- 
any, features "special reports" which would 
be of interest to nurses. 
Examples of the reports featured during 
1966 are "Venereal Disease" (March- 
April), "Speech and Hearing Disorders" 
(May-June), "The Nation's Health Man- 
power" (July-August), and "Gastrointes- 
tinal Disorders" (September-October). 
Composed of numerous charts, graphs 
and illustrations, these reports offer a fund 
of interesting facts. 
Also published by Parke, Davis and 
Company, Ltd., "as a service to physicians," 
is their booklet Therapeutic Notes - and 
its French counterpart Notes Therapeuti- 
ques. 
Containing more description and fewer 
charts and illustrations that the first book- 
let, Therapeutic Notes features several 
articles in an attractive magazine format. 
Besides the regular "ten-second abstracts," 
articles on such topics as infectious mono- 
nucleosis, bites and stings, and eye dis- 
orders in the aging patient have appeared 
in the past year. 
Nurses can have their names added to 
the mailing lists of either publication by 
writing, individually, and specifying which 
publication, to Parke, Davis and Company, 
Ltd., 5910 Cote de Liesse Rd., Montreal 9, 
P.Q. 


The proceedings of the International 
Symposium on Physical Activity and 
Cardiovascular Health, which was sponsor- 
ed by the Ontario Heart J;'oundation 
together with the Ontario and Canadian 
Medical Associations, are now available at 
a cost of $3.00 each. 
This Symposium, held in October, 1966, 
included 31 speakers and 43 discussants 
at a gathering of 550 persons in the various 
fields of medicine and physical education. 
Orders for the proceedings should be sent 
to the Ontario Heart Foundation, 247 
Davenport Road, Toronto 5, Ontario. 
THE CANADIAN NURSE 25 



help wanted in Antigua, Burundi, 
Columbia, Ghana, India, Jamaica, Kenya, Madagascar, 
Peru, Rwanda" Sarawak" Tanzania, Tchad" Trinidad" Uganda" and Zambia. 



. 


- 


-, 


it's your world. 


These countries have a lot in common. Everyone is 
no place for you if all you have to offer is lofty 
ideals. These are countries that need realists-people 
who are ready to get down to work. And come down 
to earth. Literally. Don't kid yourself. . . signing up 
with this outfit will mean slugging it out through a 
tough, demanding job. That's the only way you'll fill 
the needs of these countries. And who knows, maybe 
you'll have a few of your own filled. What is CUSO? 
It's a national agency created to develop and pro- 
mote overseas service opportunities for Canadians. 
It arranges for the placement of qualified men 
and women in countries that request their 
services. If you're sent to a country it's be- 
cause they've asked for you. Or someone 
like you. How does CUSO work? Abroad, it 
works through different international agencies 
who all assist in the placement of personnel. 
In Canada it works through local co-ordinating 
committees, located in most universities. but serv- 


:: i 


. W.. 
 
. . ,.f 


ing the whole community. What kind of people are 
needed? People who can adapt their skills and training 
to a far-from-perfect environment. Nurses who are 
able to cope with frustrating (and often primitive) 
working conditions. Nurses who can train and super- 
vise other nurses. Nurses who can earn respect, 
and give it. Think about it. You'll know if you've got 
what it takes. What is the selection procedure like? 
Tough. Because we don't believe in sending underdevel- 
oped people to developing countries. Preliminary 
screening is carried out, where possible, by local 
committees. CUSO then nominates candidates 
to governments and agencies requesting per- 
sonnel, who make the final selection. CUSO 
also makes arrangements for preparatory and 
orientation courses. How do you apply? Get 
more information and application forms from 
local CUSO representatives at any Canadian 
.

 university, or from the Executive Secretary ofCUSO, 
151 Slater Street, Ottawa. 


cuso 


The Canadian Peace Corps 


26 THE CANADIAN NURSE 


FEBRUARY 1967 



A glimpse of nursing 
in the USSR 


This article is a thumbnail sketch of observations made by Dr. Mussallem during 
the Travelling Seminar on Nursing in the USSR last October. 


Helen K. Mussallem 


tI- 

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FEBRUARY 1967 


THE CANADIAN NURSE 27 



"Please fasten your seat belts. We 
will be landing at Moscow's Interna- 
tional Airport in a few minutes." 
I looked out into the dark sky and 
the clouds suddenly vanished. "Those 
are the lights of Moscow," my com- 
panion said, "and over there is the Red 
Square. " 
I felt a strange tingle of excitement 
and wonderment. What is Russia really 
like? What are the people like - the 
nurses - the hospitals - the schools 
of nursing? Is the Russian system of 
nursing so different from ours? Now, 
one of the dreams of my professional 
life was about to come true: I was 
going to find the answers to these 
questions and a thousand others during 
our month-long Travelling Seminar on 
Nursing in the USSR. 


The twain did meet 
The link between the Canadian nurs- 
ing tradition and the Russian practice 
is tenuous, but, nevertheless, real. 
During the Crimean War, while Flo- 
rence Nightingale was organizing nurs- 
ing services for the British Army, Dr. 
Pirogov was organizing them for the 
Russian. Although each had the same 
basic objective, they never met to ex- 
change ideas. 
Dr. Pirogov continued his work after 
the Crimean War, and organized all 
levels of health personnel in Russia. 
When the Soviet system of public health 
services was inaugurated simultaneous- 
ly with the establishment of Soviet 
power in 1917, much of Pirogov's 
system was retained. 
After the Crimean War, Miss Night- 
ingale returned to England where she 
promoted and developed high standards 
of nursing education and nursing prac- 
tice. Her revolutionary ideas spread to 
virtually aU English-speaking countries 


Dr. Mussallem, Executive Director of the 
Canadian Nurses' Association. was a mem- 
ber of the WHO Travelling Seminar on 
Nursing in the USSR. This article was not 
submitted to the USSR Ministry of Health 
for approval. 
28 THE CANADIAN NURSE 


in every part of the world. 
Now, 100 years later, 23 nurses who 
had been educated in modified patterns 
of the Nightingale system, were to meet 
with nurses and doctors of the Soviet 
Union who were products of the Piro- 
gov system. 
Participants from many lands 
My Travelling Seminar colleagues 
were chief nursing officers in their own 
countries and literally came from the 
four corners of the world, or, more 
exactly, from the six World Health 
Organization Regions: Africa, Latin 
America, Eastern Mediterranean, Eu- 
rope, South-East Asia, and Western 
Pacific. We were in the USSR to learn 
about the entire health program and 
especiaUy about nurses and nursing. 
But we were to learn much more than 
that. We were to see cities, towns and 
villages in four Republics, meet the 
people, view the treasures of the past, 
participate in festivities, and return with 
a better understanding of this vast 
country of mystery, commitment, and 
contrast. 
Our colorful group convened at the 
Central Institute for Advanced Medical 
Studies in Moscow on October 6. 
Native costumes from Japan, the 
Sudan, India, Malaysia, Tanzania, and 
other countries displayed the splendor 
of the color spectrum. 
In the minds of all were many 
questions and some apprehension about 
what lay ahead. Certainly the warmth 
and friendliness of our colleagues in the 
Soviet Union left nothing to be desired. 
Even though the language barrier sep- 
arated most of us, this was quickly 
overcome through the six interpreters 
who were always at our disposal. 
Free health services 
The Seminar was opened the first 
morning by the Deputy Minister of 
Health of the USSR who explained to 
us the basic socialist principles on 
which the health services are based. 
We soon realized that it was essential 
to have an understanding of these 
principles to appreciate how the meth- 
odologies had evolved. 


The Deputy Minister spoke with 
great feeling of the importance of 
nurses. He said that he hoped this 
Seminar would be more than an ob- 
servation of the health and nursing 
services in the Soviet Union and that 
the nurses from the countries repre- 
sented would share their experience 
with their Soviet counterparts. This we 
did. 
The Minister told us that when 
Soviet power was established in 1917, 
the importance of health care was re- 
cognized, and its availability to aU citi- 
zens, even in the most remote areas, 
was regarded as a vital function of the 
state. The constitution of the USSR 
states emphatically that each individual 
has a right to maintenance in sickness, 
disability and old age. AU health ser- 
vices are available free to all citizens 
( and to visitors, as we were soon to 
learn) in the Soviet Union. 
We were impressed with the great 
improvements made in health services 
since 1917. For example, at that time 
there were 46,000 middle medical 
workers - the group to which nurses 
belong, 1.4 doctors per 10,000 popu- 
lation, and 13.0 hospital beds. The 
average life span was 44 years. Today, 
there are 1,620,000 middle medical 
workers, 23.2 doctors per 10,000 po- 
pulation, and 93.1 beds. The average 
life span is 66 years for men and 73 
for women. The measures used to ac- 
complish these improvements were a 
revelation to us. 
Central control for health services 
Major planning for all health ser- 
vices in the 15 republics is a function 
of the Central Ministry of Health in 
Moscow. Here, the regulations for the 
administration of all hospitals - 
including nursing services - are 
established. These regulations cover all 
sizes of hospitals from the large, com- 
plex, oblast hospitals in the metropo- 
litan areas to the very smaU feldsher. 
and midwife units on collective farms 
in remote parts of this immense 


· A feldsher is a category between physi- 
cian and nurse: a "junior doctor." 
FEBRUARY 1967 




 


. 



 
- 
-r , 
country . 
We toured all types of hospitals and 
health services in which nursing was 
involved, in four of the Republics: 
... "'" Russian, Ukranian, Georgian, and Ab- 
khazian Autonomous Soviet Socialist 
Republic. In these republics we visited 
large cities, such as Moscow, Kiev, 
, Tbilisi, and Vinnitsa, and small com- 
munities, such as Sukhumi, and Tul- 
chinsk. We noted that the patterns 
of health service in every community 
generally followed the regulations spe- 
cified by the Central Ministry in 
Moscow. 
- 
, Labor code protects worker 
, The administration of nursing ser- 
,.,. vices in the hospitals is unlike that of 
Canada. The main differences stem 
. from the differences in ideologies and 
\ . basic principles of management. In the 
i ,. ( .. 
\ USSR, legal regulations govern the em- 
ployment of all workers, including 
those in medical and paramedical fields. 
) The labor code gives protection to the 
worker and certain statutory powers to 

 
 the trade unions. These are related to 
such matters as improvement of work- 
ing conditions and scrutiny of the 
f labor legislation. 
, The legal labor regulations of all 
citizens are founded on principles of 
- socialist management of labor as con- 
tained in the Constitution. We were 
\ told by the head of the Labor Pro- 
tection Department at the Central Com- 

 mittee for Medical Workers that the 
fundamentals of socialist labor legisla- 
,í' tion include: 
1. The universal obligation to work. 
2. A guaranteed right to work. 
3. Guaranteed remuneration of work 
depending on the quantity and qua- 
, - lity of that work. 
..... 4. A labor discipline and the ob- 
...... servance of internal labor regula- 
tions. 
5. Guaranteed safety and health con- 
ditions of labor, legislation restric- 
tions on working hours, and a 
I guaranteed right to rest. 
.. 6. Assistance in the improvement of 
qualifications and general educa- 
tional standards of workers and the 
right to assistance and maintenance 
FEBRUARY 1967 THE CANADIAN NURSE 29 



in case of disablement as determin- 
ed by the law and at the expense 
of the State. 
Everyone works for the State and is 
paid by the State. There is no private 
enterprise, nor is there private practice 
by doctors, nurses or any other 
workers. Physicians, nurses, and other 
health workers are assigned to hospitals 
on a full-time basis. Public health 
functions are carried out by personnel 
of polyclinics, dispensaries, and felds- 
her units who visit and give health care 
in the home or anywhere in the com- 
munity. 
All workers in the health field - 
doctors, nurses, and even students - 
belong to the same trade union. There 
is no voluntary professional associa- 
tion like the CNA. Membership in the 
trade union provides generous benefits 
in relation to housing, vacation and 
recreation. Individual excellence and 
achievement is rewarded through addi- 
tional money or through the provision 
of better living accommodation. 
Living accommodation for nurses is 
arranged by the State and is provided 
at a very minimum rate - usually at 
five rubles (approximately $5.00 Cana- 
dian funds) per month. It is difficult, 
however, to compare nurses' salaries in 
the USSR with salaries paid to their 
counterparts in other countries, since 
the economic systems are basically 
different. When we acknowledge that 
so many services are provided - full 
maintenance during retirement, holi- 
days at very minimum expense, in- 
expensive food and clothing - we then 
recognize that the nurse's wages, from 
60 to I 10 rubles a month, are quite 
sufficient to provide a comfortable 
living and enjoyment of the recreational 
and cultural offerings. For comparison, 
doctors are paid. about 100 to 150 
rubles per month. 
No nursing hierarchy 
The chief physician in every hospital 
is also its chief administrative officer. 
The chief nurse is directly responsible 
to this doctor and, essentially, is his 
assistant. The senior nurse of a depart- 
ment is directly responsible to the 
30 THE CANADIAN NURSE 


senior physician and works under his 
direct supervision. Together they super- 
vise the nursing services provided in 
that department or unit. 
There is no nursing service depart- 
ment and no direct line of authority 
between the chief nurse, the senior 
nurse, and the staff nurse. "We do not 
believe in a nursing hierarchy," I was 
told. Essentially, the doctor, nurse, and 
auxiliary personnel work together as a 
team, with the doctor in charge. This 
pattern also prevails in polyclinics and 
in other health units. 
Often we received the impression 
that duties were interchangable and 
that the person most available at the 
time performed the necessary task - 
such as assisting a patient back to bed 
or holding a crying infant. It was diffi- 
cult to identify the various categories 
of personnel since all wore the same 
uniform - a white smock over street 
clothes and a white "surgeon's hat." 
Also, the majority of personnel in the 
health services are women, which adds 
to the identification problem. About 70 
to 75 percent of the doctors, the ma- 
jority of the feldshers, and all of the 
nurses are women. 
Staffing of medical services 
Three categories of workers provide 
health care: the upper medical workers, 
which include physicians and stomoto- 
logists (dentists); the middle medical 
workers, which include the nurse, 
feldshers, and midwives; and the lower 
medical workers, who act as assistants 
to the middle medical worker. 
The staffing patterns of hospitals - 
oblast, rayon, uchastock, polyclinics, 
etc. - are determined by special re- 
search and laid down in regulations 
by the Central Health Ministry in 
Moscow. However, each hospital is 
permitted to have more personnel in 
various categories, provided the request 
is justifiable. We were told that addi- 
tional staff could be requested from the 
personnel office of the appropriate 
institutions at any time. The ratio of 
staff to patients varies according to the 
severity of illness and the age group. 
For example, the ratio is more favor- 


able in units for acutely ill children 
than in units for convalescents. In a 
children's hospital the ratio may be 
one nurse to 6, 8, or 12 patients, and 
in a convalescent unit, one to 25. 
Doctors, too, are on the wards full 
time. 


Everyone works 
The Trade Union carefully regulates 
the hours of work for each citizen. The 
total work week is usually 41 hours 
with additional remuneration provided 
for overtime. 
Usually a hospital department has 
two shifts of nurses who work a six 
and one-half hour day; however they 
may work up to 12 hours. In some 
institutions, a nurse may work for 24 
hours and then be off duty for the 
next two days. 
Everyone in the USSR has both the 
obligation to work as well as the right 
to work. Unlike the situation in most 
countries represented at the Seminar, 
the Soviet nurses work for their normal 
span of years regardless of family 
status. They are allowed maternity 
leave of 56 days prior to and 56 days 
following the delivery of a child, and 
their children are cared for in creches 
or by relatives. 
Each health worker is required to 
work where she is assigned for the 
first three years after graduation. After 
this she may move to a hospital of her 
choice, but her freedom of movement 
is somewhat controlled by various 
methods. Following the three years of 
work in the assigned area, usually in 
a rural part of the country, nurses 
specialize in various fields such as diet 
therapy, physiotherapy, electrocardio- 
graphy, operating room assistant, phar- 
macy assistant, etc. Indeed, it is cus- 
tomary for her to continue with spe- 
cialization, but she usually has the right 
to choose the specialty she will pursue. 
Thus, there is not a proliferation of 
professioñs or occupations in hospitals, 
but rather one profession with various 
degrees of specialization. 
"Bolshoi spasibo" 
Throughout our whole tour, both in 
FEBRUARY 1967 



the hospitals and ministries, the warm, 
friendly hospitality overwhelmed us. 
We quickly learned to say "spasibo" 
for thank you; however, because of the 
abundant hospitality, we asked our in- 
terpreters for a word that expressed 
more than that, and soon progressed 
to "bolshoi spasibo." At every institu- 
tion we were greeted in a room that 
had tables filled with cut-glass com- 
potes of grapes and apples. Candies, 
booklets, and small broaches that de- 
picted their famous men were distribut- 
ed freely. Before we left, the nurses 
always came to our transport with a 
bouquet of flowers for each of us. 
The hospital visits usually began 
with greetings from the chief doctOl: 
and chief nurse. With the portable si- 
multaneous translation equipment and 
six interpreters, the language barrier 
almost disappeared. Following intro- 
ductions, we toured the departments 
and were able to ask questions and re- 
ceive answers "on the spot." 
The size of departments and number 
of rooms depended on the nature of the 
hospital. In general, the patient settings 
were not unlike those in many Cana- 
dian hospitals except, in the hospitals 
we toured, the patients' beds were 
closer together. Usually five beds rather 
than three or four occupied a ward. 
The wards were very white: white 
beds, white linen, white walls. The doc- 
tors and nurses all wore white hats and 
gowns over their street clothes. Some- 
times we, too, donned the white gown 
and hat. The patients appeared to be 
well cared for and we sensed a warm 
relationship between them and the staff. 
In particular, we noted the very sensi- 
tive care provided for sick children. In 
the children's hospital more color was 
used and there was a less regimented 
appearance. 
The operating rooms, polyclinics, 
and other health services had a physi- 
cal appearance not unlike those in Ca- 
nada, even though the categories of 
workers and their relationships were 
different. 
The nurses in each department of 
the hospitals worked under the direc- 
tion of the physician and as his assis- 
FEBRUARY 1967 


tant. The doctor generally carried out 
all medical procedures, including blood 
transfusions, intravenous and intramus- 
cular injections. 
A typical school of nursing 
What are the schools of nursing like 
in Russia? My visit to one of the 
middle medical schools gave me some 
insight. After a very warm greeting and 
a lecture by the director, a woman 
physician, we toured the school. 
The classrooms were bright and 
cheerful and the nursing students look- 
ed young and lively. As we went from 
room to room we saw them practicing 
procedures - procedures - proce- 
dures. In the first classroom they were 
practicing bandaging, and they all look- 
ed so attractive even with the bandaged 
eyes, limbs and bodies. They had on 
clean white smócks over street clothes 
and white caps. I went over to speak 
to a small group without an interpreter. 
"Pajolsta," I said and they knew it 
meant "please." It was one of the few 
Russian words I knew and I was mere- 
ly trying to comment. However, they 
unwrapped the bandages and put them 
on all over again. They were tickled 
when I tried to speak in Russian from 
my Guide Book. The interpreter came 
to my rescue, but I refused. "Bolshoi 
spasibo." Nurses do not need interpre- 
ters in these situations. 
But there were more than nurses 
being prepared in this middle medical 
school. Feldshers, midwives, children's 
nurses, laboratory technicians, and 
other health personnel also attend this 
school to receive their training. 
The education of these workers, as 
for all workers, is free. The Ministry of 
Public Health in the USSR has a De- 
partment of Medical Education that 
deals with all matters pertaining to 
every level of health worker education. 
The Minister is responsible for plan- 
ning and approving the curriculum, 
which is uniform for all 630 schools in 
the 15 constituent republics. Each of 
the republics has its own Minister of 
Health who is responsible for supervi- 
sion and guidance at the local level. 


However, the Central Ministry in Mos- 
cow retains the function of inspection 
of the educational program as well as 
revision of the curriculum. 
There are more than 330,000 
students in the 630 middle medical 
schools, with the largest percentage 
being prepared as nurses. The length of 
the educational program for nurses de- 
pends on the student's educational 
background. For example, if the stu- 
dent has 8 years of schooling (incom- 
plete secondary education), the length 
of the course is 2 years and 10 months; 
if she has 10 years of schooling (com- 
plete secondary education), the course 
is I year and 10 months. 
Courses taught by physicians 
Physicians administer the middle 
medical schools and teach all the nurs- 
ing subjects. Although no nurses are on 
the staff of the middle medical schools, 
they sometimes supervise students in 
the clinical field. General education 
subjects, offered to those with incom- 
plete secondary education, are taught 
by general education personnel. 
One middle medical school that we 
visited prepares 1,200 students, of 
whom 780 are nurses. This ratio is 
fairly common for all middle medical 
schools throughout the Soviet Union. 
The teachers are physicians, but do 
not have special advanced preparation 
in pedagogy. Instead, committees on 
methods of teaching are formed to im- 
prove the method and quality of the 
educational program in the schools. 
The teachers at the middle medical 
schools are usually on the medical staff 
of a nearby hospital where students 
obtain their clinical experience. They 
keep current on new medical advances 
by attending the Institute for Advanced 
Medical Studies where special courses 
are available. 


Recruitment not a problem 
At the present time, recruitment of 
students into nursing is not a problem. 
We were told that to expand the USSR 
health programs to the desired level, 
a larger number of nurses and other 
medical personnel is required. Last 
THE CANADIAN NURSE 31 




 
\ .- - 
... 
" .. 
 
,. \. 
'. . 
" , 
, 
. ." ..... 

 
. 
, , \' 
t. .. 
--- \ 
....,.... 
.... 0 
,
l ... 
.... 
... 
,. 

 , ". 
9- 

 - 
\ 


" 
" 


'" 

 


" 
.. 


Ñ 


-II 


32 THE CANADIAN NURSE 


FEBRUARY 1967 



year, 107,000 students were admitted 
and 120,000 admissions are planned 
for this year. The teachers from middle 
medical schools visit secondary schools 
to talk about nursing as a career, and 
prospective students are invited to 
"open door days" at middle medical 
schools. When students visit the middle 
medical schools, the teachers explain 
the program and the opportunities 
available. Married students with or 
without children are permitted to enter 
the school and those who become preg- 
nant are given academic leave. There 
are no student organizations, but stu- 
dents have the option of becoming 
members of a trade union. This mem- 
bership offers many advantages and 
almost 95 percent of the students join 
during their first year. 
Curriculum set by educators 
Unlike Canada, where the control 
of educational programs is centered in 
service agencies, the program of in- 
struction in the USSR is prepared by 
an educational board of the Ministry of 
Public Health. Members of this board 
are experienced and highly skilled spe- 
cialists. They meet periodically to re- 
vise the common curriculum and the 
academic program for the middle med- 
ical schools throughout the consti- 
tuent republics. This board also out- 
lines the ways in which the curriculum 
should be implemented, prescribes the 
textbooks to be used, and selects the 
authors to write the textbooks. 
The following pattern is used for 
all schools of nursing throughout the 
country. Each year is divided into two 
semesters. The first semester begins 
September 1 and lasts until January 
11; the second begins January 26 and 
lasts until July 5. All students have 
winter vacation from January 12 to 25, 
and summer vacation from July 6 to 
August 31. The students have a 35- 
hour week and a 6-hour day. This time 
may be spent on theory, practice or 
visits, depending on the level of the 
student in the educational program. 
The curriculum is divided into three 
cycles: cycle one is devoted entirely 
to general education; cycle two, to 
FEBRUARY 1967 


general medical subjects, as well as to 
anatomy, physiology, pharmacology 
and biology; and cycle three, to the 
special or clinical subjects, which in- 
clude general care of patients, surgical 
diseases, obstetrics and gynecology, 
children's diseases, eye diseases, etc. 
The total planned hours of the curricu- 
lum are 3,774, of which 2,516 are 
devoted to class work and 1,228 to 
practical experience. 
The objective of the course for the 
preparation of nurses is "to train future 
nurses in the tending of patients and 
in medical skills." A review of the 
curriculum and observations made dur- 
ing visits at middle medical schools 
revealed that the educational program 
is disease and procedure-centered, with 
emphasis placed on medical equipment. 
Diseases and health teaching are em- 
phasized. Only a very small portion of 
the outline stresses the practice of 
nursinE! as an art and a skill. 
At the completion of the basic edu- 
cational program, students write State 
examinations. Successful candidates re- 
ceive a diploma of certification and 
are then assigned to a place of em- 
ployment for three years. The top 5 
percent in any graduating class are en- 
couraged to proceed to the higher med- 
ical institutes to become doctors - 
and the majority do. The remainder 
of the students who complete the three- 
year assignment may, until they are 30 
years of age, apply to the higher medi- 
cal institutes to become doctors. 
Often we were told during the Tra- 
velling Seminar that the goal of most 
middle medical workers, including 
nurses, is to become a physician, be- 
cause "nurses conduct medical treat- 
ments and apply medical equipment 
only in accordance with prescriptions 
and instructions of the physician in 
charge of the patient." 
Unlike the Canadian system, all stu- 
dents attending middle medical schools 
live at home or in special apartments. 
The only exception to this is when the 
middle medical schools are located in 
the far north or where the homes of 
the students are a long distance from 
the school. 


A window in the iron curtain 
Although the program was very full 
with little time for relaxation, we man- 
aged to squeeze in a swim in the Black 
Sea. The same night we packed for the 
twelfth time and returned to Moscow 
to complete our assignment. On the 
next night, our last in Moscow, the 
Ministry planned a dinner party for us. 
After the party, a companion and I 
walked up Gorky Street to the Red 
Square. I shall never forget the beauty 
of the moment when we looked through 
the falling snow across the Square. 
There were the beautiful cathedrals 
with their gold bubble domes accen- 
tuated by the soft flood lights. I looked 
over to Gums Department Store where 
we had struggled in queues to make 
small purchases, then back to Lenin's 
tomb with the young soldiers standing 
stiffly on guard. Then, into my view 
came the gilded crescent and the five 
pointed red stars of the Kremlin, muted 
now by the falling snow. I could feel 
the past and the future there, but main- 
ly the throbbing of the present. 
We turned and trudged back to our 
hotel. We hardly spoke. I was thinking 
of all we had done and seen in the 
past month, the nurses and doctors we 
had met, and how committed they were 
and how far they had come in so rela- 
tively short a time. I realized that they 
were very much like all of us going 
out to work each day, coming home 
each night, and living their lives much 
as we do. 
Those of us in the first Travelling 
Seminar on Nursing in the USSR re- 
turned to our native lands with many 
different impressions. We all agreed, 
however, that it had been a rewarding 
and exciting professional and personal 
experience. For us there are now win- 
dows in the Iron Curtain. 0 


THE CANADIAN NURSE 33 



Estrogen replacement therapy 
at menopause 


John Fitzgerald Kennedy, in his in- 
augural address, challenged the 1960's. 
He called on a new generation to find 
better solutions for old problems in a 
rapidly changing world. In medicine, 
a steroid revolution became one of 
the fascinating developments of this 
decade as two new freedoms, closely 
allied, reached fulfillment for many 
women: freedom from undesired preg- 
nancy and freedom from premature 
old age. 
The impact of oral contraception 
on our generation needs little com- 
ment. Ten million women throughout 
the world now use these estrogen-pro- 
gestogen combinations for ovulation 
control and/or therapeutic purposes. 
Their safety and effectiveness have 
been repeatedly demonstrated by in- 
numerable government agencies and 
concerned medical investigators. Minor 
problems, experienced by a small per- 
centage of patients, capture dramatic 
newspaper and magazine discussion; 
for the "pill" causes symptoms similar 
to those of pregnancy, and with about 
the same frequency. Variations in the 
chemical structure and dosage of the 
constituent steroids will evolve; but 
oral contraceptives arc here to stay, 
and doctors and patients, politicians 
and sociologists must now adjust to 
their astonishing role in modern so- 
ciety. 
Most oral contraceptives inhibit 
normal pituitarv ovarian function, so 
that these medications substitute for 
circulating steroids usually obtained 
34 THE CANADIAN NURSE 


The average woman outlives her ovaries by 25 years. Estrogen from the corner 
drug store will correct this deficiency more naturally than 
tranquilizers and psychotherapy. 


Donald C. McEwen, M.D., F.R.C.S. ( C), F.R.C.O.G., F.A.C.O.G. 


, " 


Dr. McEwen. a graduate of the University 
of Manitoba, is an Obstetrician and Gyne- 
cologist in Calgary. Alberta. He is on the 
staff of the Calgary General, Grace. Rocky- 
view, and the Holy Cross Hospitals. 


from normal ovarian function. It is 
not widely appreciated that in pre- 
scribing these agents, a doctor creates 
ovarian deficiency and, paradoxically, 
treats it at the same time; for with 
treatment, ovarian function becomes 
one of suspended animation. 
Some doctors, willing to prescribe 
these powerful drugs to young women 
with normal ovaries, remain reluctant 
to offer similar hormones to women 
suffering from true ovarian deficiency, 
a result of normal aging, congenital 
insufficiency, disease, surgery, or ra- 
diotherapy. Little attention was paid 
to the menopause in medical school. 
Most doctors were taught that the 
menopause was a natural phenomenon, 
hormone treatment potentially danger- 
ous and one to be condemned from 
a long-term point of view. 
The concept of ovarian deficiency 
as a medical entity is, however, gain- 
ing recognition. If it is a valid clinical 
condition, one in every three women 
alive is a victim to a greater or lesser 
degree. Ovarian senescence may be 
rapid or gradual; but the result is the 
same. Estrogen blood levels decline, 
ovulation does not occur, and pro- 
gesterone is not elaborated. The meno- 
pause, or failure of menstruation, oc- 
curs when these hormones are insuf- 
ficient to ripen endometrial tissue. The 
climacteric encompasses a wider span 
from the time ovarian function falters 
until that occasion when total failure 
occurs, usually about age 60. Ovarian 
dysfunction is a frequent occurrence 
FEBRUARY 1967 



after the age of 35, so many women 
will suffer ovarian deficiency or im- 
balance for half their lifetime. 


Symptoms of menopause 
Symptoms suggesting an impending 
menopause are well known. The hot 
flush, usually the first symptom, is a 
sudden sensation of heat in the upper 
part of the body often associated with 
a patchy redness of the skin. Perspira- 
tion and a feeling of chilliness may 
follow. Hot flushes seem to be more 
common with increased heat produc- 
tion (stress, exercise, a hot room) or 
when heat loss is impaired (sultry 
weather, heavy bedclothes). Sleep is 
frequently disturbed and insomnia be- 
comes a common complaint. 
Pituitary overact ion may cause the 
hot flush as gonadotropin levels rise 
to stimulate estrogen production from 
aging, unresponsive ovaries. It may be 
due to fluctuating levels of estrogen. 
Excessive production of other pituitary 
tropic hormones results in an increas- 
ed stimulation of adrenal, thyroid and 
pancreatic glands, resulting in further 
systemic disturbance. 
- Fatigue, depression, and emotional 
instability may be unusually trouble- 
some at this time. Such symptoms may 
be sensitive barometers of estrogen 
deficiency, or may be a reflection of 
pituitary hypothalamic turmoil, or be 
simply manifestations of environmen- 
tal emotional influence (husband, fami- 
ly or social upheaval). 
The signs and long-term effects of 
estrogen deficiency are much more sig- 
nificant. The major physical hazards 
are degeneration and atrophy of uro- 
genital tract and breasts, blood vessels 
and bones; but the whole body is af- 
fected by a lack of estrogen. Aging 
may be accelerated and joie de vivre 
disturbed, modified from patient to 
patient by variations in the degree of 
ovarian failure, individual sensitivity 
to estrogen deprivation, the patient's 
emotional strength, called motivation, 
her ability to handle stress, and the 
infinite vicissitudes of life. 


Atherosclerosis 
Until the menopause, women are 
FEBRUARY 1967 


relatively immune to coronary artery 
disease, but thereafter become more 
susceptible. Many observations have 
been made on the effects of castration 
on atherosclerosis. Castrated young 
women have rates of arterial disease 
similar to men of the same age. Re- 
moval of ovaries at hysterectomy 
brings about a fourfold increase in the 
degree of coronary artery degeneration 
when compared to women whose ova- 
ries are left. Replacement therapy with 
estrogen lessens this risk in women. 
In controlled studies of men who had 
coronary infarction or strokes, the use 
of natural estrogens produced signifi- 
cantly longer survival and reduced the 
occurrence of secondary occlusive epi- 
sodes. Long-term studies exploring 
these possibilities continue to excite 
medical investigators. 
At present, the lesson is quite clear. 
Normal ovaries should be retained at 
the time of hysterectomy and replace- 
ment ovarian therapy is strongly indi- 
cated for those patients who show 
evidence of hypertension or cardio- 
vascular degeneration. 


Osteoporosis 
Postmenopausal osteoporosis of va- 
rying degrees occurs in practically all 
women. The degree of mineral loss 
is directly related to the severity of 
ovarian failure and the elapsed time 
of estrogen depletion from all body 
sources. This is an insidious, overlook- 
ed, and sometimes crippling disease. It 
may manifest itself clinically by low 
back pain from even minor trauma, 
shortening of stature, or dorsal kypho- 
sis (dowager's hump). Loss of density 
of bones by roentgenograms is a late 
sign. Elderly women fill our orthopedic 
wards with fractured hips, and many 
more who pass through the later stages 
of life suffer much distress from back 
and pelvic degeneration. Men do not 
suffer this affliction with any signifi- 
cant frequency. 
The cause of osteoporosis remains 
debatable; but the consensus of opinion 
suggests it is due to increased bone 
resorption resulting from long con- 
tinued negative calcium balance. 
Estrogens taken orally constitute 


the most effective and universally ac- 
cepted treatment of osteoporosis, asso- 
ciated with physiotherapy to restore 
maximum physical activity, and dietary 
regimens to supply sufficient minerals, 
and to keep patients in positive nitro- 
gen balance. 
Genital atrophy 
It is estrogen that brings about t.he 
metamorphosis of a girl to a woman, 
stimulating breasts and genital tract 
and the whole body to maturity. It is 
the withdrawal of estrogen at the time 
of ovarian failure that reverses this 
process. Resorption of fat and loss of 
elastic tissue make breasts and external 
genitalia smaller and less full. The 
vulva becomes thin, irritable, and often 
itchy. The vagina and uterus become 
small and atrophic, supporting struct- 
ures weaken, and genital prolapse is 
a frequent consequence. Urinary tract 
tissues share this estrogen dependency. 
and urinary dysfunction manifests by 
urgency, frequency, and urinary infec- 
tions. Stress incontinence also may be 
part of a common and stubborn defi- 
ciency syndrome. 
There is, therefore, considerable 
evidence that estrogen is protective to 
the mature woman, her cardiovascular 
system, bones, genital tract. joints, 
skin, and possibly every tissue in her 
body. Estrogen offers protection against 
psychological involution, apathy and 
negativism. The logical conclusion 
must be that adequate estrogen levels 
should, if possible, be maintained in 
women; that estrogen throughout a 
whole lifetime offers hope for positive 
health. 


Clinical study of ovarian deficiency 
For the past three years this con- 
cept has been explored in some depth. 
By September 1966, 777 women with 
symptoms and signs of ovarian defi- 
ciency of varying degrees were consi- 
dered for supplemental or replacement 
estrogen therapy. Thousands of pa- 
tients appeared in other doctors' of- 
fices as the potentialities of this therapy 
became known throughout the female 
population .These negìected women in- 
dicated in the only way possible their 
THE CANADIAN NURSE 35 



personal concern and disenchantment 
for traditional treatment of the meno- 
pause. 
A variety of treatment schedules 
to manage different clinical situations 
and to individualize patient needs is 
essential. These can be broken down 
into two simple types: treatment for 
the patient whose uterus has been re- 
moved, and treatment for the patient 
whose uterus is intact. 


1. The patient whose uterus has 
been removed: These patients simply 
require sufficient daily estrogen to 
achieve maximum well-being and re- 
store vaginal maturation indices to 
normal. A progestogen alone or com- 
bined with added estrogen may be 
added for five days a month for ba- 
lance; but this is not essential, for en- 
dometrial shedding is not required. The 
metabolic action and biological need 
of progesterone-like steroids remain 
obscure and ill-defined at the present 
time. 
Natural estrogens (conjugated estro- 
gens, equine), marketed as Premarin, 
are preferred as the selected estrogen, 
being well-tolerated, effective, and 
uniquely beneficial in the treatment 
and prevention of atherosclerosis. 
2. The patient whose uterus is in- 
tact: Most patients who have not had 
hysterectomy fall into four groups: 
age 35-50 (perimenopausal); age 50-60 
(menopausal); age 60-70; and age 70 
upward. 
Age 35-50 (perimenopausal): 
If ovulation control is desired, one 
of the combined or sequential estrogen- 
progestogen packets will fulfill treat- 
ment purposes. Individualization is 
essential. The combined tabulation is 
indicated where menorrhagia has been 
a problem to reduce both the duration 
and quantity of bleeding. The sequen- 
tial package is preferred where there 
has been gross disturbance of the 
menstrual cycle, particularly if bleed- 
ing has been scant or painful. 
If ovulation control is not impor- 
tant, natural estrogens (conjugated es- 
trogens, equine) are useful and well- 
36 THE CANADIAN NURSE 


tolerated, and are prescribed from 
Day 1 to Day 21 of each cycle. One 
of the combined tabulations completes 
therapy from Day 22 to Day 26 to in- 
duce medical curettage on Day 28. 
This cycle can be easily modified for 
convenience by shortening or prolong- 
ing the estrogen phase. 


Age 50-60 (menopausal): 
The patient with gross ovarian de- 
ficiency, as indicated by failure of 
menstruation, hot flushes or other 
symptoms and signs of the menopause, 
requires sufficient daily estrogen to 
satisfy her needs as determined by 
relief of symptoms and, helpfully, but 
less important, by the vaginal cyto- 
gram. Once this has been accomplish- 
ed with the use of conjugated estro- 
gens, (equine 0.625 mg. to 2.50 mg. 
daily), medical curettage is induced 
monthly with one of the combined es- 
trogens and progestogens. in doses of 
0.5 mg. to 2 mg. of the progestogen 
for 5 to 10 days, in addition to the 
basic daily therapy with natural estro- 
gens. The dosage and duration of this 
medical curettage regimen is indivi- 
dualized after a few months according 
to the patient's behavior, the length 
and amount of menstrual flow, well- 
being, etc. 
Patients are allowed to decide the 
day of their menstrual flow by simple 
instructions; menses will occur two to 
three days following cessation of the 
medical curettage tablets. The menstru- 
al flow should be scant, short, and 
without significant distress. There 
however if intermenstrual bleeding 
after the first two months of therapy; 
however if inter-menstrual bleeding 
occurs, diagnostic curettage is indi- 
cated particularly if the bleeding does 
not respond to increased estrogen dos- 
age. 


· Mestranol O. J mg. and ethynodiol diace- 
tate, .S mg., J mg. (Ovulen), and 2 mg. (Me- 
tnden) were used in 55 percent of patients 
in this series, and 
re supplied by G.D. 
Searle and Company of Canada. 


Age 60-70: 
After the age of 60, the production of 
endogenous male hormone subsides to 
low levels. If continued menstruation 
is objectionable, the regimen may now 
be changed to one of a combined es- 
trogen and androgen tablet for cycles 
of 25 days a month. The patient's well- 
being, a positive nitrogen balance, and 
adequate vaginal cornification indices 
are maintained. Menstrual function 
comes to an end, although in some 
patients slight withdrawal bleeding may 
occur when therapy is interrupted. 
Age 70 upward: 
Small amounts of estrogen, andro- 
gen and geriatric vitamins given in 
combined tabulation for 25 days a 
month have been found most useful 
to maintain vigorous old age, with 
local estrogens given vaginally for uro- 
genital integrity. 
Such regimens allow easy individual- 
ization of each patient. The objective 
of this program is to extend middle 
age for women by 10 years, and, there- 
after, to supply supportive anabolic 
steroids into old age. Sufficient ex- 
perience has now been obtained to in- 
dicate that this can be accomplished 
with few treatment problems. Such 
therapy appears safe, inexpensive and 
rewarding in its physical and emotional 
benefits. The basic concept of treat- 
ment is similar to the use of thyroid in 
myxedema, or insulin in diabetes mel- 
litus. 


Discussion 
If there is a need for lifelong estro- 
gen, and if treatment is easy, what then 
are the usual arguments against such 
therapy? 
Estrogen-Cancer Relationship 
No convincing proof that estrogen 
has caused cancer in a human being 
has ever been established, in spite of 
a widespread feeling among some doc- 
tors and some laity that the opposite is 
true. Cancer of the breast is more 
treacherous in pregnancy when estro- 
gen excretion levels are extremely high; 
but this association is rare, having an 
incidence of about three breast cancers 
FEBRUARY 1967 



in 10,000 pregnancies. In endometrial 
cancer, there may be evidence of a 
long-standing estrogen influence, and 
this lesion occurs with increased fre- 
quency in association with estrogen- 
producing tumors of the ovary, and in 
ovarian polycystic disease (Stein-Levin- 
thai syndrome). This association does 
not indicate any definite carcinogenic 
relationship, but likely reflects an ab- 
sence of progestational medical cu- 
rettage, for cyclic menstruation is ca- 
ture's method of endometrial deter- 
gence. 
The rarity of cancer in women with 
normal ovarian function, the insigni- 
ficant number of reported cases of 
breast or genital cancer in women 
taking birth control pills or other es- 
trogen therapy, the absence of experi- 
mental evidence that estrogen incites 
cancer, suggest there is little signifi- 
cant estrogen-cancer relationship. 
Continuing Menstruation 
Menstrual function is not a pleasant 
phenomenon. A waste of time, messy, 
expensive, often uncomfortable, it is 
understandable that, for most women, 
the menopause offers welcome relief 
after about 400 monthly cycles, less 
the normal interruptions of pregnancy 
and lactation. 
But menstruation is an excellent 
monitor of ovarian and uterine func- 
tion. Normal cyclic menstruation is a 
reassuring indication that physiological 
replacement ovarian therapy has been 
achieved. Women with ovarian de- 
ficiency obtain maximum benefit if 
normal estrogen-progestogen levels of 
these hormones are created. A 
natural consequence will be menstrua- 
tion. This is accepted by most patients 
in the 50 to 60 age group when its 
significance is discussed. These women 
consider menstruation a small price 
to pay for relief from menopausal 
symptoms, with the additional pos- 
sibility of delayed aging of many vital 
organs and functions. 
Expense 
Replacement ovarian therapy costs 
between $15.00 and $50.00 per year, 
depending on the steroids selected and 
FEBRUARY 1967 


the desired replacement. Cigarets cost 
$150.00 a year; weekly hairdressing 
averages $200.00. This therapy must 
be considered inexpensive in any com- 
parative study with clothes, cosmetics, 
alcohol or travel. 
Tampering with Nature 
This argument is the most superficial 
of all. Doctors, nurses, and the healing 
professions generally, wage a constant 
battle against nature's hazards. Anes- 
thesia, modern surgery, antibiotics, 
blood transfusions, immunization, and 
pasteurization are examples of tamper- 
ing with nature. And who would argue 
against their use? The person who be- 
lieves that the menopause is a natural 
process defies nature every day by 
wearing clothes, eating foods or driving 
cars. Modern man flies against gravity 
and sends rockets to the moon. 
Nature has fallen behind medical 
progress, for the average woman will 
outlive her ovaries by 25 years. 
Estrogen from the corner drugstore 
will correct this deficiency more natur- 
ally than tranquilizers and psycho- 
therapy. 
What About Men? 
The argument that there are already 
too many elderly women and widows 
in the world, and the question "What is 
to be done for men?" is much more 
pertinent. Doctors interested in this 
concept for women are concerned with 
adding abundance rather than years to 
life. In men, male hormones, hyper- 
tension, and atherosclerosis are bad 
associates, particularly when linked 
with the stress of the market place, 
unfulfilled ambition, cigaret smoking, 
obesity, and lack of physical fitness. 
These influences become complicated 
when assessed individually. Generally, 
to the extent that a menopausal wife 
can, with hormones, enjoy a fulfilled 
middle age, men can approach the 50's 
certain that their wives will remain 
feminine - emotionally, physically, 
and sexually - down the road of life. 
It is hoped that this may be a strong 
influence on longevity as the other 
problems of male aging are studied and 
conquered. 


Summary 
The case for lifelong estrogen for 
women has been discussed. Experience 
in studving 777 women who have been 
assessed for this treatment suggests 
overwhelming acceptance of the basic 
concept. There is need for wide appli- 
cation of its potential benefits to the 
millions of women suffering actively 
or passively from ovarian deficiency, 
particularly after the menopause. 0 


THE CANADIAN NURSE 37 



A wealth of articles recommendmg 
the use of estrogen both before and 
after the menopause have appeared in 
the literature of the medical and para- 
medical professions for several ye.ars 
now. Some authors have even sug- 
gested cyclic administration of an es- 
trogen-progesterone combination de- 
signed to restore a menstrual pattern 
in the menopausal woman. Whether 
or not the woman herself is desirous 
of such a result would appear to be 
a legitimate question. As one outcome 
of this literary deluge, many persons 
have wondered about and questioned 
the value of estrogens as a sort of 
legendary Fountain of Youth able to 
rejuvenate anyone who bathes in its 
waters. 
Two distinct philosophies can be 
gleaned from the mass of literary opin- 
ion on the subject of the menopause 
in general. On the one side we have 
those who consider the menopause as 
an illness and consequently believe that 
the climacteric woman should receive 
compensatory hormonal therapy in- 
definitely, however minor her symp- 
toms. On the other side are those who 
view the menopause as a period of 
physiological adjustment or adaptation 
to a new phase of life and who reserve 
hormonal therapy for the woman who 
exhibits estrogen deficiency. This phil- 
osophV represents the thinking of the 
majority of medical writers. 
In this article the indications for 
and methods of estrogen administra- 
38 THE CANADIAN NURSE 


Estrogen and the 
menopause 


Estrog('ns are by no means a panacea for all the problems of aging in women. 
They must be used knowledgeably and not simply as a tonic. 


Jean Blanchet, B.A., M.D., F.R.C.S. (C) 


, 


") 


Dr. Blanchet is on the obstetrical and gyne- 
cological service of The Montreal General 
Hospital. 


tion will be discussed and, by out- 
lining the various precautions and 
contraindications involved, it will be 
shown why hormonal therapy should 
not be used routinely or indefinitely 
in all women of menopausal age. 
Artificial menopaus(' 
A distinction must first be drawn 
between natural and induced meno- 
pause. Young women who have un- 
dergone bilateral oophorectomies or 
radiation castration necessarily re- 
quire special consideration. Compen- 
satory estrogen therapy is definitely in- 
dicated to offset the sudden and almost 
total suppression of estrogen forma- 


tion by the body, and subsequent 
premature aging. 


Natural menopause 
The menopausal phenomenon oc- 
curring as an outcome of natural ova- 
rian failure shows considerable varia- 
tion from one woman to another. Vagi- 
nal smears taken several years after on- 
set show only minor estrogen deficiency 
in most women examined. Medical 
writers are in general agreement that 
only 15 to 25 percent of menopausal 
patients have symptoms that warrant 
hormonal therapy. In actual fact, only 
the hot flushes experienced by the 
climacteric woman are directly due to 
hormonal deficiency. Other symptoms 
such as depression, anxiety, and in- 
somnia are temporary manifestations 
of psychological problems. The me- 
nopause is essentially a physiological 
process which is only occasionally as- 
sociated with a hormonal deficiency. 
Compensatory therapy is indicated 
only for those women who show mark- 
ed symptoms of this deficiency. 


Diagnosis 
The estrogen-deficient menopausal 
patient is easily recognized by a his- 
tory of hot flushes, night sweats, leu- 
corrhea, bloody vaginal discharge, as 
the result of a vaginitis or atrophic 
cervicitis. Cytology results confirm the 
suspicion with the finding of a low 
percentage of cornified cells. The 
atrophic vaginal mucosa shows an 
FEBRUARY 1967 



abundance of immature and parabasal 
cells. Cytology has become part of 
routine examination. It is easily per- 
formed and can be carried out as 
readily in the doctor's office as in 
the laboratory. 


Clinical signs 
Laboratory and clinical findings de- 
monstrate the result of hypoestrinism. 
There is atrophy of the secondary 
sexual characteristics and of the sexual 
organs, with senile vaginitis. Excessive 
activity of the anterior hypophysis is 
manifested by hot flushes and night 
sweats. Metabolic changes occur with 
associated hypercholesterolemia, athe- 
rosclerosis and hypertension. Osteo- 
porosis may develop as well. 


Hormonal therapy 
Women who experience acute, in- 
tractable vasomotor disorders that do 
not respond to symptomatic therapy 
are candidates for estrogen therapy 
until their symptoms disappear. Osteo- 
porosis and atherosclerosis are the two 
conditions to be feared in those pa- 
tients suffering from acute estrogen 
deficiency either at the time of the 
menopause or later. Osteoporosis of 
the spinal column may appear as late 
as five years after the onset of the 
menopause. Backache is the usual 
complaint characterizing this condition 
although spontaneous fractures may 
occur as the process continues. Radio- 
logical examination is necessary to 
confirm the presence of osteoporosis. 
Hormonal therapy can slow down and 
even prevent further degenerative 
changes while the patient's energy, 
strength and general sense of well- 
being are augmented. 
Atherosclerosis, with its attendant 
threat of myocardial infarction and 
hypertension, most commonly affects 
males rather than young women. How- 
ever, the incidence tends to become 
the same for both sexes after the age 
of 60 if the woman shows signs and 
symptoms of hypoestrinism. About 20 
to 25 percent of patients require com- 
pensatory hormonal therapy. Cyclical 
administration of estrogens has a 
preventive function in this instance. 
Estrogens should be administered 
cyclically, simulating the physiological 
release of hormone by the body - for 
example, three weeks' administration 
followed by one week's rest. This 
pattern avoids continual stimulation of 
the endometrium with its attendant 
dangers: hyperplasia and neoplasia. 
The smallest effective dose is the 
maximum dose that should be used. 
Duration of treatment is governed 
by clinical response and evidence of 
maturation of the vaginal tract. Theo- 
retically a patient can be treated in- 
FEBRUARY 1967 


definitely but as a general rule this is 
unnecessary. 
Complications 
Estrogen administration, especially 
in. synthetic form, is accompanied by 
nausea and vomiting in a certain 
number of patients. A weaker dose 
or the use of natural estrogens fre- 
quently overcomes the difficulty. The 
main problem for the woman with 
an intact uterus is vaginal bleeding. 
Investigation to rule out the possibility 
of organic etiology is indicated, other- 
wise a decrease in the dosage of es- 
trogen or the addition of androgens 
frequently eliminates this complication. 
Such bleeding is always a source of 
anxiety and should never be treated 
lightly. 


Contraindications 
A careful assessment of the patient's 
physical state should precede the de- 
cision to prescribe estrogen therapy. 
A past history of breast cancer or 
cancer of the genital tract precludes 
estrogen administration. The presence 
of carcinogens in this hormone has 
not been proven but laboratory find- 
ings and the clinical effects observed 
in relation to breast cancer indicate 
the need for extreme caution. Patients 
with a history of cardiac failure must 
also be excluded from such treatment. 
Any patient who complains of menor- 
rhagia or metrorrhagia at the time of 
or after the menopause should have 
complete medical investigation in- 
cluding gynecological examination, va- 
ginal cytology, and, in many instances, 
uterine curettage to rule out the pres- 
ence of other disease entities. 
Estrogens are contraindicated in 
the presence of jaundice or hepatic 
dysfunction. Liver function tests are 
recommended even in the absence of 
overt symptoms. Most doctors hesitate 
to prescribe estrogens if the patient 
has had thrombo-embolism or is suf- 
fering form thrombophlebitis or vari- 
cose veins. They exercise great caution 
if there is evidence of cardiac or renal 
disease, hypertension, epilepsy, or 
asthma. The possible effects of hor- 
monal administration on calcium and 
phosphorus metabolism must not be 
overlooked in those patients demons- 
trating irregularities in metabolism of 
these substances. 
The development of severe head- 
ache, impaired vision, migraine, di- 
plopia, or any other neuro-ophthalmo- 
logical condition requires immediate 
withdrawal of estrogen therapy. The 
same procedure applies if changes in 
the visual field, retinal hemorrhage or 
papillary edema are detected. 
In the case of the diabetic patient, 
estrogen therapy may alter insulin 



 


requirements. The woman who has had 
an earlier psychiatric problem, par- 
ticularly a depressive state, must be 
carefully supervised throughout her 
course of therapy. Any indication of 
recurrence of the psychiatric condition 
requires immediate cessation of hor- 
monal therapy. 
Non-hormonal therapy 
About 75 to 80 percent of meno- 
pausal women retain an adequate pro- 
duction of estrogens as has been 
proven by vaginal cytology; either the 
ovaries are not totally atrophied or 
estrogen production is taken over 
by the adrenal glands. Explanation 
and reassurance are two of the great- 
est aids to these patients with occa- 
<;ional recourse to light sedation or 
mild doses of tranquilizers. 


Conclusion 
The successful management of the 
menopausal syndrome calls for good 
sense, sympathy, and patience. Com- 
plete opposition to the use of hor- 
monal therapy is as much to be de- 
plored as empirical administration to 
every menopausal patient. The latter 
philosophy seems particularly unjus- 
tified when it is remembered that less 
than one-quarter of menopausal 
women exhibit signs and svmptoms of 
hvpoestrinism. The administration of 
hormones must be undertaken thought- 
fully, 
nd carefully supervised as the 
foregoin!:( consideration of contraindi- 
catiõns to hormonal therapy and the 
precautions to be taken has indicated. 
o 


THE CANADIAN NURSE 39 



Drug distribution may be described 
as the procedure by which a drug gets 
from outside of the hospital to the 
inside of the patient, with the primary 
object of getting the right drug into 
the right patient at the right time. 
The total process involves the phy- 
sician, the nurse, the pharmacist, and 
the patient. The physidan plans the 
course of drug therapy and evaluates 
its results, the pharmacist dispenses 
the required drugs, the nurse adminis- 
ters them, and the patient, in most 
cases, accepts them with trusting re- 
signation. But this statement is an 
oversimplification for in the modem 
hospital a horde of people are involved 
in the execution of any single task. 
It has been estimated that more than 
20 different people are involved at 
one time or another in the procedures 
for getting a single dose of a drug 
into a patient. 1 
The responsibilities of nursing and 
pharmacy in the drug distribution pro- 
cess have been delineated as adminis- 
tration and dispensing respectively. 
However, these activities do not take 
place in a vacuum; they are interde- 
pendent and frequently overlap. Nor 
do they always take place in complete 
harmony. One administrator has been 
driven to write that "many adminis- 
trators agreed that if they could get 
pharmacy and nursing to cooperate 
fully, many other problems would dis- 
solve.":! Life should be so simple! 
The aim of this paper is to exa- 
mine those areas of drug distribution 
40 THE CANADIAN NURSE 


Nurse and pharmacist 
-partners 


The mutual responsibilities of pharmacy and nursing in drug distribution. 


Jack L. Summers 


which are of mutual concern to phal- 
macy and nursing, some of the prob- 
lems which arise, and some means of 
minimizing these problems. 
Methods of dispensing 
Two basic systems of dispensing 
drugs have been in use in hospitals for 
many years: the floor stock system and 
the individual prescription system. 
The Floor Stock System is one in 
which all but infrequently used drugs 
are stocked on the nursing station. 
While this system provides the nurse 
with an immediate supply of most 
drugs, it is costly in terms of nursing 
time, space requirements, and inven- 
tory, and it lacks control. 
In the J ndividual Prescription Sys- 
tem practically all medication orders 
are dispensed by a pharmacist in the 
form of an individual prescription for 
a specific patient. This system pro- 
vides a high degree of inventory con- 
trol and ensures that the physician's 
drug orders have been interpreted by 
a pharmacist. But the system requires 
a great deal of dispensing time without 
a compensating reduction in nursing 
time. And unless the system functions 
with flawless precision, a most un- 


Mr. Summers is Professor of Pharmacy, 
University of Saskatchewan. He is also Edi- 
tor of The Hospital Phamacist, and until 
recently, Assistant Director, University Hos- 
pital, Saskatoon. He served on the Com- 
mittee on Nursing Education that prepared 
the Tucker Report. 


likely event, there are delays in the 
arrival of medications at the nursing 
units. This system was popular when 
patients were charged for individual 
medications, a situation which still 
exists in some hospitals in the United 
States. 
The system now in use in most Ca- 
nadian hospitals is a combination of 
the floor stock and individual pres- 
cription systems. A limited number of 
frequently used drugs, not commonly 
considered prescription drugs, are 
maintained as floor stocks. These in- 
clude analgesics, laxatives, antiseptics, 
and intravenous fluids. The remaining 
drugs are supplied on an individuàl 
prescription basis. 
Some interesting work is being done 
in the development of more effective 
svstems of drug distribution. However, 
this work is largely experimental and 
at the present time no practical alter- 
native to the traditional svstems is 
readily applicable to Canadian hos- 
pitals. 
Drug order cycle 
From the time that a drug is 
ordered by a physician until it is ad- 
ministered to the patient, a sequence 
of events takes place which, for the 
want of a more descriptive term, shall 
be called the drug order cycle. A brief 
examination of these events will illus- 
trate the involvement of pharmacy and 
nursing. 
. The physician decides on a 
course of drug therapy and orders the 
FEBRUARY 1967 



drugs to be administered to his pa- 
tient. This information is communi- 
cated to the nurse and entered in the 
patient's record. 
. The drug is ordered from phar- 
macy. If the drug is maintained as 
floor stock, the request to pharmacy 
is in the form of periodic requisitions 
for floor stock replenishment. If the 
drug is not in the ward stock, an in- 
dividual prescription order is transmit- 
ted to pharmacy. This may involve the 
nurse in recopying the physician's 
original order. 
. When the prescription order is 
received in pharmacy, it is interpreted, 
and the appropriate drug selected, 
packaged, and labeled. 
. The completed drug order is re- 
turned, hopefully to the floor from 
which it originated. 
. When the completed drug order 
arrives at the nursing station, it is 
scheduled for administration according 
to the physician's instructions. This 
procedure involves checking the ori- 
ginal order, storage of the drug, and 
the creation of medication tickets. 
. At the appointed time, a single 
dose of the drug is prepared for ad- 
ministration, taken to the right patient, 
and administered by the appropriate 
route. But the administration of the 
drug is not the end of the cycle. 
. The nurse observes the effects 
of the drug on the patient who may 
respond favorably, or adversely, or 
not at all. Regardless of its nature, the 
response of the patient is of impor- 
tance to the physician and is record- 
ed and communicated to him. 
. At regular intervals the physician 
evaluates the effects of the drug the- 
rapy and orders that it be continued, 
or altered, or discontinued. At this 
point the cycle ends and may be re- 
peated. 


The number of separate events in 
the drug order cycle is appalling. With 
the possibility of error accompanying 
each event and the introduction of 
each new person into the interpretation 
and transmission of the physician's 
order, the wonder is not that there 
is an occasional error but that there 
FEBRUARY 1967 


are not more of them! And in ad- 
dition to being subject to errors, this 
complex procedure is excessively de- 
manding of the time of the nurse 
Problem areas 
It would be kind to say that the 
prevalent systems of drug distribution 
are cumbersome. But what are the 
alternatives? 
Two approaches appear to be open: 
Adopt an entirely new system of drug 
distribution which will eliminate the 
present difficulties, and probably in- 
troduce an entirely new set of prob- 
lems; and improve the traditional sys- 
tems by simplifying procedures and 
utilizing better methods of communi- 
cation. 
It has already been noted that, in 
spite of considerable work on new 
methods, there seems to be no prac- 
tical alternative to the traditional sys- 
tems of drug distribution for most 
hospitals at this particular moment. 
Thus, the most productive approach 
for the immediate future appears to 
be the modification of existing systems 
to reduce the number of steps and 
people involved in the process. These 
changes should aim at reducing the 
possibility of medication errors and 
relieving the nurse of as much detail 
as possible so that she will have more 
time to spend with her patients. 
If significant improvements in the 
present methods of handling drug 
orders are to be effected, a clearer 
picture of the problem areas which 
are of mutual concern to nursing and 
pharmacy is necessary. Let us examine 
some of these areas in detail. 
Origin and transmission of individual 
prescription orders 
It is common practice for the phy- 
sician's orders to be written in an 
order book. Drug orders are then 
transcribed by the nurse to individual 
prescription forms and transmitted to 
pharmacy for dispensing. 
While the initiation of the physi- 
cian's order directly involves the nurse 
and the physician, it is important to 
the pharmacist that there be no ambi- 
guity about the intention of the phy- 


sician. The order should include the 
name of the drug, the dosage form, 
the dose, the route of administration, 
and the duration of therapy. If prob- 
lems arise at this stage, the remainder 
of the process is an exercise in error 
which may harm the patient. 
In an attempt to overcome errors 
of interpreting drug nomenclature, 
some hospitals require the attending 
physician to print the name of the drug 
in the order book or on a special drug 
order sheet. But even when the name 
of the drug is perfectly legible, errors 
of intent may occur. 
Recently a physician intended to 
order Placidyl* - a non-barbiturate 
sedative - but Flaxedil** - a potent 
muscle relaxant used to supplement 
general anesthetics - was written in 
the order book. The order was ques- 
tioned by the pharmacist, checked by 
the nurse against the order book, and 
the drug sent to the ward. The drug 
was subsequently administered to the 
patient who developed acute respira- 
tory distress. The situation was rec- 
tified by the prompt action of the 
nursing staff, but it provided an ex- 
cellent lesson to both pharmacy and 
nursing. The pharmacist should have 
been aware of the fact that potent 
muscle relaxants are normally used 
only in the operating theaters, and the 
drug should not have been delivered 
without checking with the physician 
However, the example is not cited to 
be critical of judgments but rather 
to illustrate that the intention of the 
physician is of mutual concern to the 
pharmacist and the nurse. 
The practice of transcribing the 
physician's original order, usually by 
a nurse, to a prescription form for 
subsequent transmission to pharmacy 
is questionable. It introduces a pos- 
sibility of error in transcription, a 
source of additional work, and several 
more pieces of paper to clog the 
machinery of drug distribution. 
.Placidyl - registered trade name for Ab- 
bott Laboratories brand of ethchlorvynol. 
uFlaxedii - registered trade name for 
Poulenc Limited brand of gallamine triethi- 
odide. 


THE CANADIAN NURSE 41 



The transmission of drug orders 
can be simplified by the use of a du- 
plicate drug order that provides a copy 
for the nurse and a copy for the phar- 
macist which serves as a prescription 
requisition. This procedure eliminates 
the recopying of drug orders and gives 
the pharmacists the physician's original 
order for interpretation. Questions re- 
garding the order mav be discussed 
directly with the physician by the phar- 
macist. keeping in mind that nursing 
must be informed of any change in 
the original order. 
A drug order form that appears to 
solve many of the problems of trans- 
mitting the physician's original order 
to pharmacy has been developed and 
used by Joseph Brant Memorial Hos- 
pitaJ3. 
Regardless of the system used for 
ordering a drug from pharmacy, the 
actual transfer of the order should not 
require a nurse, or a member of her 
staff, to deliver it to pharmacy. The 
pneumatic tube, or other automated 
transport device, provides a conven- 
ient delivery system. In older hos- 
pitals, the use of a routine drug or- 
der pick-up service, supplemented by 
telephone and pharmacy runner, 
should make the use of nursing staff 
as messengers an outmoded form of 
communication. 


Prescription labeling 
Dispensing is the role of the phar- 
macist. While there is little mutual 
concern with this phase of operations, 
the labeling of the prescription is of 
some importance to the nurse. The 
label should provide her with suffi- 
cient information to get the right drug 
into the right patient. In hospitals, it 
is customary to label the prescription 
with the name and location of the 
patient, the name of the prescribing 
physician, and the name and strength 
of the drug. Directions are omitted 
unless specificalIy requested because 
the nurse has a number of orders. 
card files, medication tickets, and 
other assorted sources of information 
that give her the dosage schedule of 
the drug order. One more source of 
information would but add to the con- 
fusion. 
42 THE CANADIAN NURSE 


The name of the drug which ap- 
pears on the label frequently poses a 
problem to the nurse. Drug nomen- 
clature, being the jungle that it is, 
makes it possible to label a drug with 
a variety of names, alI of which may 
be different from the name by which 
the physician ordered the drug. The 
nurse is not an expert in drug nomen- 
clature and it should not be necessary 
for her to search reference works to 
verify the fact that the name on the 
label is synonymous with that by 
which the drug was ordered. 
The source of the problem is that, 
if a physician orders a drug by its 
trade name, and a brand of the drug 
other than that calIed for by the trade 
name is supplied, the prescription 
cannot legally or ethicalIy be labeled 
with the brand name specified in the 
physician's original order. In such 
cases the common name of the drug 
should be used to identify the drug 
supplied. But when this is done, the 
label should also read "Dispensed in 
place of (brand name specified by 
physician)." Thus the nurse does not 
have to guess at the meaning of the 
common name nor phone to the phar- 
macy to see why Mrs. Jones' order has 
not arrived! 
It must be emphasized that the dis- 
pensing of a brand of drug other than 
that specified in the physician's order 
may only take place with the approval 
of the physician, or under the author- 
ity of the Pharmacy and Therapeutic 
Committee of the Medical Staff. 



 


.. ... 
. 


" 


Pre!>cription delivery 
Once a drug order has been trans- 
mitted to pharmacy the nurse should 
be relieved of further responsibility 
until the drug arrives back on her 
ward in time to meet the needs of the 
patient. But alI too frequently things 
don't happen quite this smoothly and 
there is a last minute panic to locate 
a drug which has been, or should 
have been, ordered some time pre- 
viously. 
Drug orders arrive at the pharmacy 
like bananas - in bunches - and the 
pharmacist must attempt to place a 
realistic priority on their completion. 
Some means of indicating emergency 
orders for immediate return to the 
ward should be worked out between 
pharmacy and nursing. "Stat" orders 
should not be abused to expedite the 
delivery of non-urgent drug require- 
ments. 
The mechanics of delivering drug 
orders to the wards are unimportant 
providing that they are convenient for 
both nursing and pharmacy, and get 
the drugs to the ward in time for ad- 
ministration. Delivery may be achieved 
by pneumatic tube, or some automatic 
conveyor system, by a routine delivery 
service, or pharmacy runner, or a 
combination of methods. But the me- 
thod should meet the requirements of 
the particular hospital and deliver the 
goods - on time. It is the responsi- 
bility of the pharmacist to ensure that 
it does so! 


FEBRUARY 1967 



After-hour pharmacy service 
While most of the problems of mu- 
tual concern to pharmacy and nursing 
arise in the course of the drug order 
cycle, several additional areas con- 
tribute their share of headaches. After- 
hour pharmacy service is a fairly con- 
sistent source of distress. 
The pharmacy department is open 
and fully staffed for a definite period 
of time each day. On weekends and 
holidays a reduced staff is usually 
present at certain times to provide for 
the immediate requirements of the pa- 
tient. 
The hours of operation of the phar- 
macy should reflect the demands for 
service. More than 90 percent of new 
drug orders originate between the 
hours of 8:00 A. M. and 5:00 P. M. 
Monday to Friday, and this factor de- 
termines the hours of full operation. 
However. in some hospitals the medi- 
cal staff make rounds in the early 
evening after office hours. This prac- 
tice creates a number of new drug or- 
ders and it is reasonable to e;pect 
pharmacy to provide service over this 
period. 
But, illness in general, and emergen- 
cies in particular, have refused to ob- 
serve the sanctity of the 40-hour week, 
and hospitals are required to function 
24 hours a day for seven days each 
week. Drugs are required after the 
pharmacy is closed for the day and 
there must be some procedure for ob- 
taining adequate pharmacy service 
after regular hours. 
The aim of after-hour pharmacy ser- 
vice is to provide the nurse with those 
drugs that are necessary to meet the 
immediate requirements of the patient 
without undue inconvenience to the 
nursing staff. Under no circumstances 
shoull the nurse be required to engage 
in dispensing. The system should en- 
sure that a pharmacist is always avail- 
able to discuss medication problems 
with the nurse, and to return to the 
hospital if the occasion demands. 
The ideal solution to after-hour ser- 
vice is to have the pharmacy open 
for 24 hours a day. For some lafJ.!er 
hospitals this approach is a sensible 
solution; for some it is a necessity! 
However, for most hospitals, 24-hour 
operation of the pharmacy department 
FEBRUARY 1967 


is neither practical nor necessary. But 
the responsibility for 24-hour phar- 
macy service must rest with the phar- 
macist and it is his task to come up 
with a suitable answer to his own par- 
ticular situation. 
The use of an emergency drug sup- 
ply for after-hour drug requirements 
is a common practice. The nurse, or 
more specifically the evening or night 
supervisor, is expected to go to the 
supply, select the right package, and 
leave a requisition for what she has 
taken. 
While this system does meet a need 
- the need for drugs in an emergency 
- it is time-consuming and cumber- 
some for the nurse. Indeed, it is diffi- 
cult to consider it as a service. The 
emergency drug system is much too 
often used as a substitute for adequate 
pharmacy service. 
Most medium-sized hospitals require 
something between full-time pharmacy 
service and the night supervisor as- 
suming full responsibility for the dis- 
pensing of after-hour drugs. There are 
many ways in which the required ser- 
vices can be provided, short of 24- 
hour pharmacy staffing. The extension 
of pharmacy hours on a reduced staff 
basis to cover busy evening periods 
and weekends, a pharmacist on call, 
utilization of retail pharmacists, and 
conveniently located pre-packaged 
emergency drug supplies may all con- 
tribute part of the solution. A combi- 
nation of these methods should pro- 
vide a satisfactory after-hour pharma- 
cy service for most hospitals. But the 
degree of service required by a hos- 
pital after hours, and the adequacy of 
the measures for providing it, should 
be arrived at by consultation between 
pharmacy and nursing. 
Ward stock medications 
The pharmacist is responsible for 
all drugs in the hospital, regardless of 
their location. This includes drugs 
maintained as ward stocks. 
 
There are two areas of mutual con- 
cern to the nurse and the pharmacist 
relative to ward stocks. The first is 
the list of drugs to be kept on wards 
and the second is the procedure for 
replenishing stocks of these drugs. 
The purpose of ward stocks is to 


provide the nurse with a convenient 
supply of most items used in routine 
performance of nursing care. Require- 
ments for ward medication should be 
maintained without a complicated re- 
quisitioning and accounting system 
and without the nurse being required 
to move from the \\'ard to obtain sup- 
plies. 
The selection of drugs for each ward 
should be worked o
t between the 
pharmacist and the head nurse of the 
particular ward because requirements 
vary from ward to ward. While the 
nurse may prefer to have all of her 
drug requirements readily at hand. 
there is some limit, short of the entire 
dispensary inventory, that must be 
accepted as reasonable. Floor stocks 
should not be considered as an inflex- 
ible list of drugs but rather a group 
of drugs that may be augmented or re- 
duced to meet current fashion of drug 
therapy and the type of patient on th
 
ward. 
Expensive drugs that may be readily 
consumed by other than patients. such 
as antibiotics, should not be requested 
as ward stocks. Large ward stocks 
require an increased inventory which 
defeats the purpose of central drug 
control, and, indeed, add to the con- 
fusion of preparing medications for 
patients. 
To reorder ward stocks, the most 
that should be required of the nurse 
is to check off a preprinted form. The 
responsibility for picking up orders and 
delivering the drugs to the ward at 
a convenient time rests with the phar- 
macist. 
Some hospitals no longer use ward 
stock requisitions. The pharmacist 
brings the drugs to the wards, checks 
the existing supplies, and brings them 
up to a scale of issue previously agreed 
upon with the staff of the nursing 
unit. A modification of this system is 
a mobile ward stock unit which is 
wheeled up to the ward to replace the 
old unit which is taken back to the 
pharmacy for replenishment. 4 


Narcotic control 
The responsibility for accounting 
for narcotics and "controlled" drugs 
falls upon both the pharmacist and the 
nurse. 


THE CANADIAN NURSE 43 



While the law is quite specific as to 
what must be done, pharmacy and 
nursing can work together to develop 
procedures which fulfill both the letter 
and the spirit of the regulations with- 
out creating too great an inconve- 
nience to either profession. 
Requisitioning procedures should 
require only the signature of the head 
nurse or her deputy. The requested 
narcotics and controlled drugs may 
then be delivered to the ward at a 
convenient time each day. Nursing 
units should stock adequate supplies 
of narcotics and controlled drugs and 
should not be required to return an 
empty container before being allowed 
to reorder a second. This makes it 
possible for the nurse to plan her nar- 
cotic orders on the basis of a 24-hour 
requirement and prevents needless 
trips and requisitions by both pharma- 
cy and the nursing unit. 
It should not be necessary for the 
nurse to return the completed record 
of administration to the pharmacy per- 
sonally unless some problem has ari- 
sen. Under normal circumstances, it 
should be sufficient for both records 
and containers to be picked up by 
pharmacy when narcotics are deli- 
vered, or sent back with the normal 
drug returns. 
A shift count of narcotics is some- 
times required by nursing service. The 
merits of this particular form of enter- 
tainment will not be debated at this 
point. But where such a procedure is 
required, it is helpful if narcotics are 
packaged in such a manner that indi- 
vidual doses can be seen and counted 
without removing them from the con- 
tainer. This prevents wear and tear on 
both narcotics and nursing tempers. 
Many such containers are now availa- 
ble and there is no valid reason for 
not putting them to use. 
Nursing may greatly assist in the 
control of these drugs bv bringing 
problems to the attention of the phar- 
macist as soon as they are suspected. 
Narcotics that have not been used for 
some time should be returned to the 
dispensary rather than left on the ward 
for daily counting. 
Developments in drug distribution 
It is becoming increasingly obvious 
44 THE CANADIAN NURSE 


that the traditional methods of drug 
distribution are no longer adequate 
to meet the requirements of the mod- 
ern hospital. The most significant 
reasons are said to be: 
I. The high percentage of medica- 
tion errors reported in the literature 
and 
2. the widespread shortage of per- 
sonnel, especially nurses. ã 
Work is being done on the develop- 
ment of several new systems of drug 
distribution, most of which are based 
on the unit-dose system of dispensing. 
In this system, all drugs are delivered 
to the floor in single doses, labeled 
for specific patients, and ready for 
administration, immediately prior to 
the time at which they are to be ad- 
ministered to the patient. All that is 
required of the nurse is to take the 
prepared medication to the right pa- 
tient and administer it. 
The successful introduction of such 
a system will require considerable 
mental and mechanical adjustment on 
the part of both nursing and pharma- 
cy. But regardless of the problems in- 
volved, few should quarrel with the 
object of the system, which is to re- 
lieve the nurse of many of the time- 
consuming mechanical details which 
now keep her from the patient. It 
should also contribute to a reduction 
of the volume of waste paper which 
now accumulates in the nursing sta- 
tion. 1I 
Automated dispensing units of the 
vending machine type have been intro- 
duced in an attempt to improve drug 
distribution techniques. While this de- 
vice does have some very desirable 
features, it does little to improve the 
lot of the nurse. Indeed, this type of 
equipment is now obsolescent in the 
light of newer developments. 
Some of the more sophisticated ad- 
vanced systems incorporate the utiliza- 
tion of automatic data processing 
and telecommunications. Not only 
does the system deliver the required 
drugs in unit doses, but sends a mes- 
sage reminding the nurse that medica- 
tion is due for certain patients whose 
names are printed out. The machine 
calls back in 15 minutes to ask if the 
task has been completed. 7 
One of the new developments al- 


lows the physician to select and or- 
der his drug therapy on a device si- 
milar to a television screen. One gets 
the impression that the nursing station 
in the automated hospital will resemble 
a fire control unit of a nuclear bat- 
tleship. 
Many of the experimental systems 
being tested at the present time will be 
applicable only to specialized hospi- 
tals. But out of the present work will 
evolve a new system, or systems, 
which will be applicable to all hospi- 
tals, and which will solve many of the 
problems which beset both pharmacy 
and nursing in the process of drug 
distribution. 
Until new systems are developed, 
there is much that can be done to im- 
prove the present methods of providing 
drugs for patients. But to do so will 
require a genuine effort on the part 
of nurses and pharmacists to become 
familiar with their areas of mutual 
responsibilitv and to minimize the 
causes of friction which are irritating 
to ourselves and detrimental to the 
welfare of our patients. 
But regardless of the development 
of new systems, the introduction of 
automation, and the use of automatic 
data processing, the pharmacist will 
not provide the nurse with the assis- 
tance which she requires, and which 
he is capable of providing, until he 
moves out of the dispensary to where 
the action is - on the wards of the 
hospital. The shiny new tools and 
gadgets, from which so much is ex- 
pected, must be looked upon as a 
means of helping to achieve this aim. 


References 
J. Latiolais, C.J. Hosp. Manag. 94: 80. 
Sept. 1964. 
2. Biggs, E. L. The Administrator-Pharma- 
cist Relatiornhip. Canad. Hosp. 43: 44, 
June 1966. 
3. Smythe, H.A. Hosp. Pharm. 19: 103. 
May-June 1966. 
4. Victorine. Sister M. Amer. J. Hosp. 
Pharm. 15: 973, Nov. 1958. 
5. Stauffer. I.E. Hosp. Pharm. 19: 149. 
July-Aug. 1966. 
6. Barker, K.N. and Heller, W.M. Amer. 
J. Hosp. Pharm. 20: 568, Nov. 1963. 
7. Jang, R. and Barker, K.N. Mod. Hosp. 
p. 124, April 1965. 0 
FEBRUARY 1967 



Tumors of the skin are very com- 
mon, usually occurring on exposed 
surfaces such as the face or the back 
of the hands, but can appear anywhere, 
particularly if the site is subject to 
persistent trauma. Exposure to wind, 
sun, and frost are etiological factors, 
and skin tumors are more common in 
the white populations living in tro- 
pical climates and in persons such as 
farmers or fishermen who work outside. 
Tumors may be benign or malig- 
nant, are often multiple, and seen more 
frequently in the older age groups. 
Some benign lesions become malignant 
with time, and, although most malig- 
nant tumors arise primarily in the skin, 
occasionally they are a manifestation 
of widespread cancer. Metastases from 
breast and lung tumors are the com- 
monest and the malignant lymphomata 
can infiltrate the skin. 
Skin cancer usually implies tumors 
of epithelial origin and may be clas- 
sified according to histological charac- 
ters. They are generally of low-grade 
malignancy and the majority are cured 
at the first attempt. Where the first 


The author expresses his appreciation to 
Mrs. M. Gaettens of the Department of 
Medicine Photography, The Princess Mar- 
garet Hospital, for providing the clinical 
photographs, and to Mrs. M. McIntyre for 
her secretarial and typing services. 


Dr. Fitzpatrick is radiotherapist at The 
Princess Margaret Hospital. Toronto. On- 
tario. 


FEBRUARY 1967 


Tumors of the skin 


A brief description of the benign and malignant tumors of the skin, 
and their treatment. 


P.J. Fitzpatrick, M.B., D.M.R.T., F.F.R. 


planned treatment fails to cure the pa- 
tient, secondary measures are usually 
effective and few patients succomb to 
this disease. 


Benign tumors 
These lesions tend to have a long 
history. They "sit on" the skin rather 
than invade it, are frequently pigment- 
ed and multiple, involving large areas. 
The commonest is the hyperkeratosis 
(Figure 1) which presents as a rough- 
ened area of thickened skin and may 
show ulceration; in time, these may 
develop into squamous cell carcino- 
mas. Bowen's disease is intraepithe- 
Iial carcinoma that tends to occur at 
mucocutaneous junctions, particularly 
around the anus and the lip; these le- 
sions, too, sometimes progress to frank 
squamous cell cancer. The keratoacan- 
thoma (Figure 2) is an interesting 
tumor that is often misdiagnosed for 


the more serious epithelioma. The 
history is short, often of only a few 
weeks duration, with rapid growth 
commencing as a pimple that breaks 
down in the center to show a keratin 
plug. On separation this leaves an ul- 
cerated, indurated base; left to itself, 
spontaneous healing will occur with 
an average life of 12 to 25 weeks 
(Figure 3). Other benign tumors are 
mentioned for completeness but are 
outside the scope of this article (Figures 
4, 5, 6). 


Malignant tumors 
Basal Cell Carcinoma 
The rodent ulcer is the commonest 
malignant tumor of the skin. Its site 
of election is the face above a line 
joining the lobe of the ear to the angle 
of the mouth, particularly at embryo- 
logical junctional areas. The tumor 
erodes away at tissues, but does not 


Common Primary Skin Tumors 


BENIGN MALIGNANT 
Keratosis Basal Cell Carcinoma 
Wart (Rodent Ulcer) 
Angioma Squamous Cell Carcinoma 
Keloid (Epithelioma) 
Nevus (Mole) Malignant Melanoma 
Keratoacanthoma Bowen's Disease 
THE CANADIAN NURSE 45 



metastasize and usually is not a serious 
condition, although large tumors can 
produce hideous deformities. It starts 
as a small lump that breaks down in 
the center and refuses to heal. Growth 
is slow and the edges of the tumor 
are pearly white in appearance with 
numerous small blood vessels present. 
Squamous Cell Carcinoma 
Epithelioma frequently arises in as- 
sociation with other skin changes due 
to climatic exposure or trauma. It is 
therefore more common on exposed 
parts of the body and grows directly 
by extension into the surrounding tis- 
sues, sometimes metastasizing to the 
regional lymph nodes. It starts as a 
pimple or ulcer that will not heal and 
growth may be rapid. The edges of 
the ulcer are raised, rolled, and everted 
and the base bleeds easily (Figures 
7, 8, 9, 10). 
Malignant Melanoma 
This tumor is less common than the 
epithelioma and may occur anywhere 
on the skin, most commonly around 
the orbit or on the limbs. It has a 
sinister reputation because of its black 
color and its tendency to re::ur locally 


Fig. 1: Seborrhea keratosis on the left 
cheek of a 66-year-old farmer. It was 
present for 2 years, growing slowly, 
and bleeding at touch. Treated with 
single shot of irradiation. 


Fig. 4: Keloid scar on the back of lobe 
of an ear following piercing. No 
treatment given. 


46 THE CANADIAN NURSE 


if inadequately treated. There is a high 
incidence of metastases that may ap- 
pear as satellite nodules around the 
primary tumor (Figure 1/) or spread 
through the lymphatics to the regional 
nodes. Involvement of other organs, 
particularly the lungs and liver due to 
bloodstream spread, is common. The 
tumor is not always pigmented and it 
may follow change in a benign nevus; 
occasionally there is a history of rapid 
growth or bleeding associated with 
pregnancy. This tumor carries the 
worst prognosis of any skin tumor. 


Patient management 
At The Princess Margaret Hospital. 
patients are seen in a special skin clinic 
where a history is taken' and clinical 
examination carried out. Following 
this a diagnosis is made which is usual': 
Iy followed by a biopsy to confirm the 
clinical impression. A photograph is 
useful in following the subsequent 
progress of the tumor and occasionally 
x-rays are required to see whether 
there is any bone destruction or to 
search for the presence of metastases. 
Irradiation has been used in the 


Fig. 2: Keratoacanthoma on nose of a 
57-year-old man. Present for 6 weeks. 
growing rapidly. but not bleeding, 
Treated with simple curettage. 


Fig. 5: Angioma on the head of a 
2-month-old baby. Tumor disappeared 
spontaneously without treatment over 
a 3-year period. 


{I 


treatment of skin tumors for over 60 
years. The therapeutic use of radiation 
depends on its ability to destroy se- 
lectively abnormal tissue without dam- 
aging the adjacent normal structures. 
This is accomplished by various treat- 
ment techniques and the physical pro- 
perties can be adapted to suit any 
tumor and site. Many techniques have 
been used and the radiation obtained 
from radioactive isotopes or x-ray ma- 
chines. Radium has been the isotope 
used most extensively and is still used 
in the form of needles that can be im- 
planted into the tumor, or as a sur- 
face applicator; however, these now 
have been replaced for the most part 
by external irradiation from an x-ray 
machine. 


Radio-isotopes emit radiation of dif- 
ferent types by disintegration of the 
nucleus, the gamma ray being used for 
therapeutic effect. These rays are simi- 
lar to x-rays and related to those of 
light, heat and radio, but are of ex- 
tremely short wave lengths. Radiation 
is absorbed in tissues and its depth 
of penetration depends on several fac- 
tors. In general, the higher the voltage 


. 


Fig. 3: Same patient as in Figure 2, 
four months later. 


Fig. 6: Benign papilloma in the left ear 
of a 72 - year-old man. Present most of 
his life but recent bleeding due to 
trauma. Tumor removed by curettage. 


.. ') 
... 


, 


FEBRUARY 1967 



the greater the depth dose achieved. 
Thus, at 100 KV, the useful depth of 
irradiation is about 4 mm.; deeper 
tumors have to be treated with more 
powerful units. 
Rodent ulcers and epitheliomas are 
moderately radiosensitive and can be 
readily destroyed by radiation. If the 
tumor is small, a single treatment will 
suffice and is useful in treating {)1d 
people, especially if they have had to 
travel from afar. Larger tumors have 
to be treated over several days to get 
a cancericidal dose that will not dam- 
age the normal surrounding structures. 
A better cosmetic effect is obtained 
and the chances of getting a geogra- 
phic miss, possible with a single shot 
treatment, eliminated. 
Most tumors are superficial and low 
voltage x-ray machines operating at 
less than 100 KV provide effective 
treatment. For thicker lesions a higher 
voltage at 250 KV is required. Today, 
high energy electrons and other radio- 
active isotopes, such as Caesium 137. 
increase our therapeutic armory. 
Following irradiation, the tumor 
develops an erythema and subsequent- 


Fig. 7: Epithelioma on left hand of 
a 49-year-old laborer. Present for 8 
months and growing rapidly. Treated 
with rodium nwld. 


Fig. 10: Same patient as in Figure 9. 
Result shown 18 months later. 


FEBRUARY 1967 


ly becomes covered with a ycllow fi- 
brinous exudate; this reaches its maxi- 
mum intensity after about two to three 
weeks and becomes slightly sore. 
Crusting follows. On separation four 
to six weeks following therapy, the 
.tumor is found to have disappeared, 
although complete resolution some- 
times takes a little longer. The cosme- 
tic result is usually good and repre- 
sented by minor atrophy of the skin. 
although telangiectasia may occur after 
treatment of large tumors many years 
later. Recurrence is uncommon and 
probably best treated by excision be- 
cause of the danger of necrosis fol- 
lowing heavy irradiation. The latter 
follows damage to the blood vessels 
of the skin which develop an endarte- 
ritis with subsequent deficient nourish- 
ment and oxygenation of the involved 
area. 
Unfortunately the malignant melano- 
ma is not a radiosensitive tumor, al- 
though small ones can be destroyed by 
heavy irradiation. These tumors are 
best excised and it is generally accept- 
ed that any excision that does not re- 
quire skin grafting is inadequate. Irra- 
diation is used to supplement surgery 


..... 


i\ 
 
 


Fig. 8: Same patient as in Figure 7. 
Result shown 4 years later. 


Fig. 11: Malignant melanoma on left 
foot of a 67-year-old man. Present for 
many years. Tumor excised and 
grafted, but patient died of distant 
metastases three years later. 


where the latter may have been in- 
complete, and is useful in palliating 
the symptoms of advanced disease. 
The techniques used at The Princess 
Margaret Hospital and the common 
reactions encountered and their man- 
agement will be described in the fol- 
lowing article. After treatment, skin 
tumors are followed in the outpatients' 
clinic to assess the result 0 


- 


.. 


p. 


" 


Fig. 9: Epithelioma lower lip present 
for 6 months. Treated with external 
irradiation. 


THE CANADIAN NURSE 47 



During the past eight years, one out 
of every five new patients registered 
at The Princess Margaret Hospital in 
Toronto had some form of skin cancer; 
in fact, nearly 5,000 new patients were 
seen and treated. 
Most patients are treated on an out- 
patient basis; very few need to be ad- 
mitted to hospital. If patients come 
from outside the city, they can be 
accommodated in The Princess Mar- 
garet Lodge, which is situated about 
100 yards from the main hospital. 
Room and meals are provided at the 
Lodge, but the patient is able to go out 
and follow whatever pursuits he likes. 
The skin clinic in the outpatients' 
department is staffed by a consultant 
dermatologist and radiotherapist. They 
examine each patient, make a diag- 
nosis, and prescribe treatment. The 
patient is then escorted by a volunteer 
to the radiotherapy department and 
introduced to the radiographer who ex- 
plains the course to be followed. 
Description of department 
The radiotherapy department is de- 
signed to make treatments as efficient 
and pleasant as possible. Radiation 
used therapeutically produces no haz- 
ard to the patient; but irradiation in 
small doses received over a long period 
of time by personnel working in the 
therapy departments is hazardous. Cer- 
tain precautions are taken to mini- 
mize exposure. The walls of the treat- 
ment room are of thick concrete and 
the observation windows contain lead 
48 THE CANADIAN NURSE 


Radiation therapy for 
skin cancer 


Minimizing the patient's fear about the diagnosis of cancer and the method of 
treatment is a major responsibility of the radiotherapy technician. 


Doris Martyn, Reg. N., R.T. 


so that no stray radiation can filter 
to the outside. Because of the dangers 
of radiation exposure, the technician 
is not allowed to be in the room at 
the same time as the patient while 
treatment is being carried out, but ob- 
serves him through the specially pro- 
tected window. 
The treatment rooms are pleasantly 
decorated and spacious to prevent 
claustrophobia. As there are no out- 
side windows, murals of outdoor scenes 
cover one wall. A two-way communi- 
cation system has been set up so that 
technician and patient can converse at 
all times while therapy is in progress. 
To encourage relaxation, soft back- 
ground music is piped into all treat- 
ment rooms. 


Radiotherapy 
The doctor prescribes the amount 
and type of radiation required and 
specifies the area to be treated. This 
varies according to the nature of the 
tumor and its extent. The prescription 
is written on a special treatment sheet, 
and unless the treatment is compli- 
cated or extends for more than five 
days, the doctor will not see the pa- 
tient again until the first follow-up 
visit in the outpatient clinic. The radio- 
grapher is now responsible for the 
planned treatment and for establishing 
rapport with the patient. 


Miss Martyn is Senior Radiotherapy Tech- 
nician at The Princess Margaret Hospital. 
Toronto, Ontario. 


When external irradiation is to be 
used, the patient is placed on a treat- 
ment couch with the appropriate area 
exposed. Treatment for each patient 
is individualized. The regular set of 
applicators are suitable for a good 
proportion of the patients, but some 
situations require special shields that 
can be made to any size or shape. 
Most skin cancers are treated with 
superficial x-ray at 100 kilovolt. A 
very thin sheet of lead (0.5 millimeters 
thick), which can be cut with scissors, 
prevents any radiation from passing 
through it. Large tumors are treated 
at a moderate voltage and the shield- 
ing has to be thicker to prevent irra- 
diation of the surrounding normal tis- 
sues. The doctor will have marked the 
area to be treated with a skin pencil. 
This is then outlined with the appli- 
cator or lead cut-out and the x-ray 
machine is placed in position. Patients 
who are comfortable will maintain 
their position better than those who 
are not, and if there is any danger of 
movement the part to be treated is 
supported by sand bags. 
The patient is told again that the 
treatment is painless but that there 
will be a whirring sound from the ma- 
chine which is quite normal and no 
cause for alarm. The technician re- 
treats from the room, shuts the door, 
calculates the treatment time, and 
turns on the radiation beam. Most 
treatments take only a few minutes. 
When the prescribed dose has been 
given, the machine automatically turns 
FEBRUARY 1967 



-.--.. 
 


= 


o 


.- 


itself off and the technician re-enters 
the room, releases the x-ray applicator, 
and removes any shields. 
Protection badges worn 
To make sure that nurses and tech- 
nicians do not receive irradiation 
beyond the maximum permissible level 
as outlined by the World Health Or- 
ganization, protection badges are worn 
and blood counts taken periodically. 
The protection badge consists of a 
small x-ray film, which is sensitive to 
radiation. The badge is worn on the 
chest of the technician and any ex- 
posure of radiation can be determined 
by the subsequent development of the 
film. 


Treatment of rodent ulcers 
Rodent ulcers around the eyelids 
are common. At this site special lead 
shields have to be placed inside the 
lids to protect the underlying eye 
(Figures 1, 2, 3, 4). The shields are 
made out of lead with the concave con- 
junctival surface coated with a thin 
layer of plastic. Several sizes and 
shapes are available and one is select- 
ed to suit the patient. They are stored 
dry, but prior to use are soaked in 
1:750 solution of aqueous zephiran for 
half an hour and then rinsed in sterile 
water for five minutes. 
To anesthetize the eye we use 0.5 
percent pontocaine; two drops are 
placed in the lower conjunctival sac 
and repeated after five minutes. Five 
minutes later, the eye shield, lubri- 
FEBRUARY 1967 


Fig. 1: A 52-year-old man with ulcer 
below the left .eye. The ulcer had been 
present for 1 year, was growing slowly, 
and bleeding on occasion. Biopsy 
confirmed the present of a rodent ulcer. 


Fig. 2: Same patient showing the area 
to be irradiated marked out and an 
internal eye shield in position. 


cated with mineral oil, can be inserted 
by slipping it under the lower eyelid 
and lifting the upper eyelid over it. 
After treatment the shield is removed 
and 10 percent sulphacetamide drops 
are instilled into the lower fornix to 
prevent subsequent infection, together 
with one or two drops of mineral oil 
to minimize irritation. A pad and ban- 
dage are applied until sensation has 
returned which usually occurs within 
one to two hours. Without the pro- 
tective bandage, a piece of grit could 
lodge in the eye and produce damage 
without the patient being aware of it. 
If a single treatment has been pre- 
scribed, the nature of the subsequent 
reaction is explained to the patient. 
If further treatments are planned, a 
return appointment is arranged to fit 
in with the patient's other commit- 
ments, so as to disturb his normal 
routine as little as possible. 


Skin reactions to irradiation 
Within a day or two of being irra- 
diated, the treated skin shows a faint 
erythema which increases over several 
days. This reaches a maximum inten- 
sity after about 10 days, and a moist 
desquamation of the skin often occurs 
at this time. During this period, trauma 
to the treated area should be avoided 
and the affected skin kept dry. If dis- 
comfort occurs, Nivea Creme or lano- 
lin should be applied sparingly two 
or three times a day. If the reaction 
is unduly severe, as sometimes occurs 
in persons with fair or sensitive skin, 


... 


..; 


one percent gentian violet solution ap- 
plied two of three times a day will 
produce a scab and allow the under- 
lying tissues to heal. 
Following moist desquamation, crusts 
appear; these are best left to separate 
on their own. Separation usually oc- 
curs between the third and fourth 
weeks and a new pinkish skin is seen. 
The tumor will often have disappeared 
by this time, but sometimes a residuum 
is left. Further disappearance occurs 
during the next few weeks with no 
special treatment required apart from 
avoidance of trauma. 
The patient should be protected 
from sunlight, wind, and frost, since 
these can cause severe local reactions, 
manifested by redness, soreness, and 
weeping of the treated area, with de- 
layed healing. Infection, too, must be 
avoided or increased scarring will re- 
sult with impaired cosmetic result; the 
patient is advised against rubbing the 
area. If there is hair in the irradiated 
area, permanent epilation usually will 
result; although this is of little con- 
sequence, the patient should be warned 
about it. 
The doctor examines each patient 
about two months following treatment 
to assess the result; however, he will 
see him before this time if the need 
arises. A careful explanation of the 
reactions that follow irradiation and 
a form that gives the patient general 
instructions on management of the 
treated area usually make this earlier 
visit unnecessary. 
THE CANADIAN NURSE 49 



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Fig. 3: Patient being prepared for 
treatment. 



 


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Dressings to irradiated areas are 
not required unless the patient is ex- 
posed to trauma or dirt, in which case 
a simple cover minimizes the risk of 
infection. Follow-up of these patients 
is shared by the local doctor and the 
clinic. A patient with a rodent ulcer 
can usually be discharged from clinic 
follow-up after one year, but is ad- 
vised to see his own physician if he 
notices any skin changes at the treated 
site or elsewhere. Follow-up after one 
year is unnecessary if the tumor has 
completely disappeared because late 
recurrence is rare. 
Other malignant tumors are followed 
indefinitely because of the possibility 
of local recurrence or the appearance 
of metastases. Because skin tumors are 
frequently multiple, the precipitating 
causes are explained to the patient and 
he is advised to protect himself as far 
as possible. 


Fears 
Many patients verbalize their fears 
and apprehensions to the nurse rather 
than to the doctor. Explanations and 
reassurance will allay these fears, but 
definite answers are needed for ques- 
tions, such as "Will it burn?" 
During the Second World War, 
Norman Rockwell painted four can- 
vases entitled "The Four Freedoms." 
One of these illustrates a basic need 
of all human beings: "Freedom From 
Fear." Fear of cancer is perhaps one 
of the most terrifying fears today. As 
nurses, we face the tremendous chal- 
lenge of assisting a patient through the 
initial frightening phase following a 
diagnosis of cancer. We must try to 
give him peace of mind, a sense of 
security, assurance and hope. These 
things we have been trained to do; 
but to do it properly, we need to edu- 
cate ourselves in the modern methods 
of therapy. 0 


Fig. 4: Patient being treated. A lead 
cut-out is seen outlining the area to be 
irradiated. 


FEBRUARY 1967 



books 


Fundamentals of Public Health Nursing 
by Kathleen M. Leahy, R.N., M.S. and 
M. Marguerite Cobb, R.N., M.N. 225 
pages. Toronto, McGraw-Hill Book Com- 
pany, 1966. 


Re\'iewed by Miss Margaret Steed, nursing 
consultant, education, Canadian Nurses' 
Association, Ottawa, Ontario. 


This book was written to provide nursing 
students with the necessary guidelines in 
preparation for their experience in public 
health nursing. 
The content was developed specifically 
for use in baccalaureate pre-service pro- 
grams, designed to prepare nurses for be- 
ginning positiorn in public health nursing, 
but would be similarly applicable in a di- 
ploma program in nursing where public 
health concepts are integrated throughout the 
nursing courses. 
The information in the textbook is pre- 
sented in two parts. 
Part one is devoted to public health and 
public health nursing, the principles of 
public health nursing, together with history, 
trends and philosophy. Information is given 
specific to the home visit, and related to 
essential communication skills and statistics. 
The identification of the role of the public 
health nurse, as it is viewed on the health 
team, seems to require an excessive review 
of historical material. 
In part two, a variety of selected case 
situations and case records together with 
topics and questions suitable for discussion 
periods are offered. This part of the book 
adds to the true value of this basic textbook 
for nursing students, in that descriptions of 
actual situations experienced and problems 
encountered by public health nurses are 
narrated and designed to provide some 
insight into public health nursing and the 
skills, understandings, appreciations and 
awareness that are required and utilized. 


Geriatric Nursing, 4 ed, by Kathleen New- 
ton, R.N., M.A. and Helen C. Anderson, 
R.N., P.T., M.N. 390 pages. Saint Louis, 
Mosby, 1966. Reviewed by Mrs. Valerie 
Nicholson, instructor, School of Nursing, 
Calgary General Hospital, Calgary, Al- 
berta. 


Recognizing, firstly, that the word geriatrics 
is that "branch of medical and nursing 
science that deals with the treatment and 
care of disease conditions in older people, 
including constructive health practice and 
prevention of disease," and formulating, 
FEBRUARY 1967 


secondly, a philO!>ophy or concept of 
geriatrics in keeping with this - old age 
can be satisfying and need not be a period 
of idle sitting and waiting for the inevitable, 
death - the authors have organized the 
fourth edition of Geriatric Nursing into four 
major units. These include an introduction 
to the aged, and a description of health 
maintenance and illness prevention, the gen- 
eral factors in the care of the ill, and clinical 
nursing. 
Unit one emphasizes the attitudes and 
personal qualities essential to the nurse who 
deals with older people. Basic to the nurse's 
approach is a knowledge of the socio-psy- 
chological needs of the aged - "the need 
for somewhere to live, something to do, and 
someone to care" - and a thorough under- 
standing of why these basic needs are 
not met in our society. Related to the prob- 
lems of the aged is society's rejection of 
old people and its emphasis on youth and 
beauty. The authors state that the prob- 
lem, paradoxically, seems to be one of 
preserving the life of the older person on the 
one hand, while killing him socially on the 
other. 
Unit two discusses maintenance of health 
and prevention of illness. Physical care for 
the aged differs from that for younger per- 
sons. Adjustments, small in themselves, may 
mean the difference between the comfort and 
well-being of the older person and his dis- 
comfort and predisposition to disease. To 
illustrate, the authors present the adjustments 
necessary for each basic physical need, i.e., 
bathing, skin care, sleep, ventilation, rest, 
activity, posture. clothing, diet. elimination 
and safety; throughout, a general regard for 
the older person is interwoven. emphasizing 
the importance of psychological needs. More 
pictures of older people in their homes, 
rather than in hospital beds, would have 
been useful in this section. 
The authors stress the nurse's strategic 
position in teaching people of the impor- 
tance of periodic health appraisals and of 
available community services. Far. too often 
elderly persons and their family members 
interpret nornpecific symptoms as the inevit- 
able concomitants of advancing age. 
Unit three, dealing with general factors 
in the care of the iU, discusses housing 
during illness, rehabilitation. and specific 
treatments such as physical and occupational 
therapy. The home is suggested as the best 
place for the elderly patient except in the 
event of acute illness or intensive treatment 
of chronic illness. Home care programs and 
instruction for family members are included 
in the nurse's role. "Repersonalization," or 
the restoration of a sense of personal worth, 


must preceed successful rehabili1ation. 
The final unit, more tllan half of the 
entire book, deals with nursing the elder- 
ly person with diseases and is arranged 
according to body systems. Since the clinical 
approach to many of the disease conditions 
is the same for the elderly as for the 
younger person, this book specifically men- 
tions only those that pertain to the care of 
the older person. 
This book would be a valuable reference 
book in any school of nursing library be- 
cause of its detailed, thoughtful, and in- 
dividualized approach to the care of older 
people in our society. 


Psychiatry for Nurses by John Gibson, 
M.D., D.P.M. 1S6 pages. Oxford. Black- 
well Scientific Publications, 1966. 
Reviewed by Mrs. Doris DesMarteau, 
acting assistant director of nursing, The 
Ontario Hospital, Cobourg, Ontario. 
This book introduces the general duty 
nurse to psychiatry. A welcome addition to 
the works on this subject, it would be a 
useful teaching manual and handy reference 
for all mental health workers. A lucid and 
concise account of the psychiatry of child- 
hood to old age, it presents a simplified ap- 
proach to a complex subject. 
In her association with the psychiatrist, 
the nurse will constantly hear technical 
terms. If she is familiar with them, she can 
communicate more intelligently with 
members of associated professions, and read 
psychiatric literature with increased under- 
slianding. With a knowledge of certain group- 
ings of personality disturbances, she will 
have a broader insight into the nature of 
her patient's illness. 
In the introduction the author deals with 
the scope of psychiatry. He points out that 
there is no clear distinction between mental 
and physical illness, and that many physical 
diseases manifest themselves through mental 
symptoms. Mentally ill patients, like the 
physically iU, suffer from definite illnesses 
that require individual methods of treat- 
ment. 
Chapter two outlines the signs and symp- 
toms of mental illness. Subsequent chapters 
deal with neuroses and psychosomatic dis- 
orders. Schizophrenia and paranoia are 
cornidered in detail as two of the most im- 
portant psychoses. Alcoholism and drug ad- 
diction are e"plained as social as well as 
medical problems. One chapter describes 
organic diseases that commonly produce 
mental symptoms. 
Chapter fourteen defines mental subnor- 
mality as a common condition. Mental 
THE CANADIAN NURSE 51 



books 


defectives, a large part of any mental hos- 
pital's population. demand their own treat- 
ment and training that must be understood 
by the nurse. 
In the section devoted to psychiatry of 
childhood. the author emphasizes the prob- 
lems presented by mentally ill children. 
which usually differ in certain respects from 
psychiatric problems of adults. 
In his last chapter "Principles of Treat- 
ment", Dr. Gibson describes at length treat- 
ments and medications applied to many types 
of illnesses. He also mentions some qualities 
essential for the nurse who cares for mental 
patients. 
Knowledge alone does not necessarily 
make it easier to tolerate the persistent hos- 
tility. rejection. and discouragement that the 
nurse often meets, but it does help her to 
understand the sufferings of the mentally 
ill that can be deep and tragic. 


The Human Body, A Survey of 
Structure and Function by John 
Caimey, C.M.G., D.Sc., M.D., F.R.A.C.S. 
and J. Caimey. 8.Sc., M.B., Ch.8.. 
M.C.R.A. 286 pages. Christchurch, New 
Zealand, N.M. Peryer Limited, 1966. 
Re
'iewed by Miss lean W. Spaldillg, 
associate director of nursing education, 
Torolllo East General & Orthopaedic 
Hospital. 


This text is written in a clear, concise 
form that would be most helpful in an intro- 
ductory course in anatomy and physiology 
for students, who need general information 
and clarification of terminology. The dia- 
grams are excellent and adequately labeled, 
providing good visual aids. 
Chapters one to eleven provide the best 
content; later chapters, including those on 
the muscular, nervous, blood vasular, and 
endocrine systems, provide insufficient in- 
formation. 
To understand body alignment, passive 
exercises, etc., the nurse must have a 
thorough knowledge of the muscular systems, 
which this book does not provide. More- 
over, the chapter on the blood vasular sys- 
tem presents insufficient physiologic detail 
and the chapter on the endocrine system 
lacks current information. 
The anatomy in this text would be ade- 
quate but sufficient physiology is lacking. 
The major reason for teaching anatomy and 
physiology is to provide a basis for under- 
standing health and for providing nursing 
care. This text does not include the material 
necessary to give the student such a back- 
ground. Its value would be enhanced by the 
addition of questions at the end of each 
chapter for review and application, and a 
bibliography for reference. 
52 THE CANADIAN NURSE 


a show of hands... 


\ 



 


nroves its sllloothness 


NEW FORMULA ALCOJEL, with 
added lubricant and emollient, will 
not dry out the patient's skin- - 
or yours! 


ALCOJEL is the economical, modern, 
jelly form of rubbing alcohol. When 
applied to the skin, its slow flow 
ensures that it will not run off, drip 
or evaporate. You have ample time 
to control and spread it. 
ALCOJEL cools by evaporation . . . 
cleans, disinfects and firms the skin. 
Your patients will enjoy the 
invigorating effect of a body rub with 
Alcojel . . . the topical tonic. 


r . coo tin 
efreshH"\g... 9. 


ALCOJEL 


Send for a free sample 
through your hospital pharmacist. 


f 


::a, 


ALCOJEL 


Jellied 
RUBBING 
ALCOHOL 



 THE BRITISH DRUG HOUSES (CANADA) LTD. 
Barclay Ave.. Toronto 18. Ontario 


FEBRUARY 1967 



books 


Rehabilitative Aspects of Nursing, 
 
Programed Instruction Series. Part I. 
Physical Therapeutic Nursing Measures. 
Unit I. Concepts and Goals. 51 pages. 
New York. National League for Nursing, 
1966. 


This pTOgramed unit is the first of a 


series of progrdmed nursing texts planned 
by the National League for Nursing. It 
was prepared especially for inservice edu- 
cation of nursing staff and for self-instruc- 
tion by individual nurses. It is designed to 
enable nurses to learn, at their own speed. 
new facts and skills in rehabilitative nursing. 
This introductory unit is devoted to gen- 
eral concepts and goals and to the treatment 
of the patient as a whole person. Future 
books will deal with range of joint motion, 
muscle conditioning. body positioning, and 
assessment processes in rehabilitative nursing. 
The booklet is easy to use and thoTOughly 




 

 


o 
.. 
.. 
.. 
... 
II 
. 


\." 



 
DISPOSABLE 
PREP TRAYS 


Now Feature Gillette's 
New SUPER STAINLESS 
STEEL BLADE 


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Oill e " e 
SOPER snu 
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NEW. IMPROVED PREP SHAVE TRAY No. EP-108 
Sterilon EP-I09 is ready to use without preparation 
by Central Supply. . . completely disposable, eliminating the danger 
of cross contamination after use. 
Canta;ns everything needed far Surgical I'nps: 


. Non-Clogging Razor with Gillette's 
New Double Edge Super Stainless Steel 
Blade - assembled and ready to use 
. Sponge Impregnated with Hexachloro. 
phene. Lanolin and Castile Soap 
. 2 Cotton Applicators 
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. Packed in Double Compartment Tray 
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OTHER STERILON PREP TRAYS 
TO FILL YOUR SPECIAL REQUIREMENTS 
EP-I05 - Same contents as EP-I09 but with 
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Clinically clean. 
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h with all .,.,.il. di.posoble items. the packaging 
.hould always be checked. If the packaging i. 
damaged or the seal i. broken the product .hould 
not be considered .,.,.ile. 
OF CANADA, LTD, 836 RANGEVIEW ROAD 
PORT CREDIT, ONTARIO, CANADA 


FEBRUARY 1967 


covers the introductory aspects of rehabilita- 
tive nursing. The time required to complete 
all frames is approximately two and one- 
half hours. 
Much of the material i
 extremely simple 
and would appear to be more valuable to 
students than to graduate nurses. However. 
considerable attention is given to aspects of 
care that involve diagnosis, assessment, and 
establishment of physical therapeutic nursing 
measures on the nurse's own initiative, that 
is, in her OWn team TOle and without the 
supervision of other disciplines. 
The book would be a useful addition to 
any ward library. Inservice nursing educators 
would find it valuable as a supplement and 
adjunct to many teaching programs. 


History and Trends of Practical Nurs- 
ing by DOTOthy F. Johnston, R.N., B.S., 
C.P.H.N., M.Ed. 171 pages. Saint Louis, 
Mosby, 1966. 
Reviewed by Mrs. P. Ecclestone, acting 
instructor, School lor Nursing Assistants, 
King Edward VII Memorial Hospital. 
Bermuda. 


This interesting book outlines the events 
that have shaped and brought into existence 
the present-day practical nurse or nursing 
assistant, as she is known in Canada. Five 
of the nine chapters deal with the past, two 
with the present, and one with the future 
of this auxiliary worker. 
The author traces the development of 
the practical nurse from the primitive 
woman who remained at home caring for 
the weak and sick while man foraged for 
food, through the religious orders, which 
provided rituals and housekeeping services 
rather than actual nursing care, to the 
beginning of the training of lay women in 
the early nineteenth century. 
In discussing the early training programs 
and the growth and expansion of the profes- 
sion, the author gets rather bogged down 
in dates and details. The reviewer found 
herself flipping pages and reading the con- 
cise and comprehensive summaries at the 
end of each chapter. 
In the chapter "War and Awakening," 
tbe author describes the professional nurse's 
realization, after World War II, of tbe need 
for the practical nurse in the hospital as 
well as in the home. The professional nurse 
finally accepted the responsibility for her 
control. Many states began passing laws for 
her licensure, curricula were expanded, her 
title was standardized, and she emerged a 
recognized and necessary part of the health 
team. 
The author discusses todays practical 
nurse in the United States and nursing 
assistants in Canada in chapters 7 and 8. 
Canadian nurses will find Chapter 8 very 
interesting, as tbe author describes the 
number of schools, admission requirements, 
THE CANADIAN NURSE 53 



books 


length and description of the course, and 
number of trained as.
istants employed in 
each province. 
In her final chapter, "Preview of the 
Future," Miss Johnston discusses the areas 
in which the practical nurse is now em- 
ployed, and conjectures about her future. 
In spite of rumblings in some camps to the 
effect that the practical nurse faces ex- 


tinction with the emergence of a "new 
nurse" who is a product of a two to three- 
year course in an independent school, the 
author believes that the outlook for the 
practical nurse is excellent, as thousands 
more are needed for employment in general 
hospitals, psychiatric hospitals, health agen- 
cies, geriatric hospitals, doctors' offices, and 
even by the Peace Corps. 
In general, this is a welI-written, thorough- 
ly researched text, and would be useful for 
instructors of nursing assistants or practical 
nurses, students themselves, and, in part, 
to professional nursing students and their 
instructors. 


TO 


PLAN FOR A LIFETIME 
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Marriage is a responsibility that often re- 
quires both spiritual and medical assistance 
from professional p&ople. In many instances 
a nurse may be coiled upon for medical 
counsel for the newly married young wo- 
man, moth.r, or a matu... woman. 


"To Plan For A Lifetime, Plan With Your Dac- 
tor" is a pamphlet that was written to assist 
in preparing a woman for potient.physicion 
discussion of family planning methods. The 
booklet st..sses the importance to the indi. 
vidual of selecting the method that most 
suit. her religious, medical, and psychological 
needs. 


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Nurses are invited to use the coupon below 
ta order copies for use as on aid in coun- 
selling. They will be supplied by Mead John. 
son Laboratories as a free swvice. 


M8a
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54 THE CANADIAN NURSE 


films 


History of Medicine 
The Canadian Medical Association has 
prepared a special film for Canada's Cen- 
tennial year. A Century of Canadian Medicine 
(2S-minute, color, sound) depicts the pro- 
gress of medicine Over the past 100 years. 
The film demonstrates the profession's 
commitment to the improvement of the 
nation's health. The life-and-death gambles 
with diseases such as pneumonia or tuber- 
culosis in IS67 have changed to scenes 
where medication and treatment can over- 
come the infection, and life goes on with 
little interruption. Recent advances in med- 
icine and surgery have been selected to 
show lay audiences some of the results of 
medical progress, such as open-heart sur- 
gery, care of premature babies, and the 
use of physiological monitors. 
As a secondary objective, it is hoped that 
the film will stimulate recruitment of 
young people interested in and capable of 
carrying on the traditions of service and 
science. 


This centennial film would be of inter- 
est to nurses - especially useful in his- 
tory courses and as a film to recommend 
for showings to high school students. For 
information concerning its use, write to 
The Secretary, Public Relations, Canadian 
Medical Association, 150 St. George Street, 
Toronto 5, Ontario. 


Through the Eyes of the Patient 
An unusual and excelIent teaching film, 
Candidate for a Stroke, has recently been 
added to the lists of films available from 
the Canadian Heart Foundation. In this 
film the audience sees the world as through 
the eyes of a man having a mild stroke. 
Diagnosis, treatment, and rehabilitation are 
all seen as though the audience was the 
patient. The film also concludes with the 
steps necessary to reduce the risk factors 
that lead to a cerebrovascular accident. 
This IS-minute, black-and-white, sound 
film would be valuable as a teaching aid 
in medical-surgical nursing. It may be 
borrowed from the Canadian Heart Found- 
ation, 1130 Bay St., Toronto 5, Ontario. 


Dangers of Superficial Relationships 
The Special Universe of Walter Krolik, 
a new, 2S-minute, color, sound film, pre- 
sents a patient-family story. The film was 
intended primarily for a nursing audience 
and is not suitable for a lay group. It dis- 
cusses the outcome of nurse-patient relation- 
ships when a response is made to super- 
ficial needs without an assessment of un- 
derlying needs. In this film, nurses appear 
FEBRUARY 1967 



films 


to be winning the battles and losing the 
war. 
The film would be an excellent teaching 
tool in schools of nursing, or in continuing 
education programs for graduates. It is 
directly concerned with the patient v.:ith 
tuberculosis, but many of the concepts 
are applicable to any chronic or continuing 
patient care. 
The film was prepared in the United 
States and was co-sponsored by the Na- 
tional Tuberculosis Association, the Nur- 
sing Advisory Service on Tuberculosis and 
Other Respiratory Diseases, and the ANA- 
NLN Film Service. It was made possible by 
a grant from the American Contract Bridge 
League Foundation. It may be borrowed 
from your local branch of the Canadian 
Tuberculosis Association. 


Excellent for Adolescents 
An excellent motion picture on growth 
and development for adolescent and teen- 
age girls has been produced by Churchill 
Films. Girl to Woman is a scientific and 
authoritative treatment of the sensitive 
subject of puberty, and is produced under 
medical and psychiatric supervision. Ex- 
tensive animation is used to show the 
female reproductive system and the tur- 


Nursing Studies Index 


A reVISion of the Canadian 
Nurses' Association Nursing Studies 
Index, first issued in 1964, is in 
preparation. If you know of any 
studies, i.e., masters and doctoral 
theses and studies by government 
organizations and institutions, 
which have been completed be- 
tween 1964 and 1966, or any prior 
to 1964 that were missed in the 
first issue, please notify the libra- 
rian, Canadian Nurses' Association, 
50 The Driveway, Ottawa. The 
only criteria is that the study be on 
some aspect of concern to nursing 
in Canada, or, in the case of theses, 
be conducted by a Canadian nurse. 


Also, the library is hoping to have 
as many copies as possible of the 
studies listed in the index in the 
CNA repository collection of nurs- 
ing studies. If you have only one 
copy of your study, please lend 
it to us with permission to xerox. 


FEBRUARY 1967 


bulent changes that take place during and 
after puberty. 
The film is a companion to Boy To Man, 
released a few years ago, which has re- 
mained the most authoritative film in its 
field. It would be valuable for use in schools 
as well as a teaching tool for nurses. 
The film is in color, and runs 16 minutes. 
It may be borrowed from the Canadian 
Film Institute, 1762 Carling Ave., Ot- 
taWa 13. A small rental fee is charged. 


accession list 


Publications in this list of material re- 
ceived recently in the CNA library are 
shown in language of source. The majority 
(reference material and theses. indicated by 
R, excepted) may be borrowed by CNA 
members, and by libraries of hospitals and 
schools of nursing and other institutions. 
Requests for loans should be made on the 
"Request Form for Accession List" (page 
57) and should be addressed to: The Li- 
brary, Canadian Nurses' Association. 50 
The Driveway. Ottawa 4. Ontario. 


BOOKS AND DOCUMENTS 
I. L'automation par Louis SalJeron. 4. éd. 
Paris, Presses Universitaires de France, 
1965. 125p. (Que sais-je? no. 723.) 


2. Canadian annual revieK for 1965. 
Edited by John Saywell. Toronto. Univ. of 
Toronto Press. 1966. 569p. 
3. Canadian unil'ersities and colleges /966. 
ed. by Edward Sheffield and Rosalind J. 
Murray. Ottawa. Association of Universities 
and Colleges, 1966. 335p. 
4. Communication and public relations 
by Edward J. Robinson. Columbus, Ohio, 
Charles E. Merril Books, c1966. 618p. 
5. Continuing professional educational 
lIeeds of supervisory personnel in the nursinl! 
service and nursing education; a survey of 
Pennsylvania hospitals by Sammuel S. Du- 
bin and H. LeRoy Marlow. University Park, 
Penn., Pennsylvania State Univ., 1965. 65p. 
6. La cybernétique par Louis Couffignal. 
Paris, Presses Universitaires de France, 1963. 
125p. (Que sais-je? no. 638.) 
7. The determination and measurement of 
supervisory training needs of hospital per- 
sonnel; a survey of Pennsylvania hospitals 
by Samuel S. Dubin and H. LeRoy Marlow. 
University Park. Penn.. Pennsylvania State 
Univ., 1965. I32p. 
8. Documents fondamentaux; statuts et 
règlement directives règlements intérieur 
pour les séances par Conseil International 
des Infirmières. London. 1966. 47p. 
9. Dotation en personnel des services in- 
firmiers de santé publique et de soins au.\' 
malades non hospitalisés. Méthodes d'étude. 
par Doris E. Roberts. Genève, Organisation 
mondiale de la Santé. 1965. I IIp. 


.;: 
. -
 

:::

-
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--
- -
--- 

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ostomy 
anatomical 
demonstrator 


"MINI-GUIDE" 


" 
M\lPI!:. -\..'^TUM"'Y 
o 
..... ",.
 
\0 ""./' 
"Mini-Guide" allows you to visually and 
graphically perform Colostomy, Ileostomy I1eal- 
Bladder, Wet Colostomy and Cutaneous Ureterostomy 
surgery. 
As an instructor, you are afforded a simple, effective method of teac
ing th
 surgical 
mechanics and organs involved in ostomy surgery; as a student, you Immedmtely see 
and understand the procedures o
 ostomy surg
ry; and 
s a nurse. you have the per- 
fect vehicle for visual demonstratIons to the patient who IS to undergo ostomy surgery. 
The "Mini-Guide" anatomical demonstrator is priced at $1.00 on this money-back 
offer 746 CN. 



, 
'
Jf:"- 
T..JÑJT
Ç!D

f1GJCAL 


PORT CHESTER . NEW YORK 


THE CANADIAN NURSE SS 



Next Month 
in 


The 
Canadian 
Nurse 


. Nursing 
in the 
north 


. Changes 
in nursing 
education in 
Saskatchewan 


. RN employed 
at a 
veterinary 
college 


ð 

 


Photo credits 


Expo 67, p. 7 


Globe and Mail, p. 13 


USSR Embassy, pp. 27, 29, 32 


Dept. of National Health and 
Welfare, p. 42 


56 THE CANADIAN NURSE 


accession list 


10. L'équilibre .
ympathique par Paul 
Chauchard. Paris. Presses Universitaires de 
France, 1961. 128p. (Que sais-je? no. 565.) 
I 1. Factors affectin!? the eSlllblishment of 
associate degree programs in nursing in 
community junior colleges by Mildred S. 
Schmidt. New York, National League for 
Nursing, 1966. 128p. 
12. Final report on draft legislation pre- 
pared jor the New Brunswick Association 
of Registered Nurses by Alan M. Sinclair. 
Fredericton, 1966. Iv. 
13. Governments and the university by 
York University. Toronto, MacMillan, 1966. 
92 p. (The Frank Gerstein lectures, 1966). 
14. L'hérédité humaine par Jean Ros- 
tand. 6.éd. Paris, Presses Universitaires de 
France, 1965. 126p. (Que sais-je? no.550.) 
15. History of the school for nurses To- 
ronto General Hospital by Margaret Isabel 
Lawrence (ed). Toronto, Alumni Associa- 
tion, 193 I. 63p. 
16. Nursing studies index, mi. 3, 1950- 
1956 prepared under Virginia Henderson. 
Philadelphia, Lippincott, 1966. 653p. R 
17. La projession d'infirmière en France, 
2éd. par Revue de I'Infirmière et de l'As- 
sistante Sociale. Paris, Expansion Scienti- 
fique français, 1962. 377p. 
18. Report on action prepared for the 
New Brunswick Association of Registered 
Nurses by Katherine MacLaggan. Frederic- 
ton, 1966. 63p. 
19. Le rôle de l'infirmière dans l'action 
de santé mentale; rapport sur une confé- 
rence technique, Copen hague, 15-24, nO- 
vembre 196( par Audrey L. John et al. 
Genève, Organisation mondiale de la Santé, 
1965. 214p. 
20. A series of papers presented at the 
1965 regional clinical conferences sponsored 
by the American Nurses' Association, New 
York, 1966. 6v. Contents. -1. Nursing 
practice. -2. Medical-surgical nursing prac- 
tice. -3. Maternal and child health nursing 
practice. --4. Psychiatric nursing practice. 
-5. Public health nursing practice. -6. 
Geriatric nursing practice. 
21. Les services injirmiers de santé pu- 
blique; problèmes et perspectives par Or- 
ganisation mondiale de la Santé. Genève. 
1961. 208p. 
22. The sister as a clinical specialist by 
Sister Leon Douville and Sister Marilyn 
Emminger. St. Louis, Conference of Catho- 
lic Schools of Nursing, 1966. 126p. Q 
23. A survey to determine the nursing 
care needs of patients in certain standard 
welfare wards (indigent) of the Ottawa Civic 
Hospial following their discharge from the 
hospital by Muriel V. Lowry. Ottawa, 1962. 
51p. 
24. Le système nerveux par Paul Chau- 
chard. 10.éd. Paris, Presses Universitaires de 
france, 1966. 128p. (Que sais-je? no. 8.) 


25. Les testes mentaux par Pierre Pichot. 
Paris. Presses Universitaires de France, 
1965. 126p. (Que sais-je ? no. 626.) 


PAMPHLETS 
26. Book and joumal serl'ices for doctors 
and nurses. An interim report on a National 
Book League investigation by J.E. Mor- 
purgo. London. N uffield Provincial Hospi- 
tals Trust. 1966. 41 p. 
27. A brief to the .relect committee oj the 
New Brunswick legislature on the labour 
relations act. Fredericton, New Brunswick 
Association of Registered Nurses, 1966. 
28. Directory of Canadians with service 
overseas, 1966. Ottawa. Overseas Institute 
of Canada, 1966. 478p. 
29. A guide for the nursing service audil 
by Sister Mary Helen Louise Dee1dn. St. 
Louis, Catholic Hospital Association, 1960. 
26p. 
30. A guide for the ulilizalion oj per- 
sonnel supportive of public health nursing 
service.r. New York, American Nurses' As- 
sociation, Public Health Nurses Section. 
1966. 12p. 
31. Guiding principles for the develop- 
ment oj programs in educational institutions 
leading to a diploma in nur.ring. Ottawa, 
Canadian Nurses' Association, 1966. lip. 
32. An index of care by J.A.K. MacDon- 
nell and G.B. Murray. Ottawa, Medical 
Services J. 31:499-517, Sep. 1965. Reprint. 
33. Major official policies relating to the 
economic security program. Rev. New York, 
Amerioan Nurses' Association, 1965. 14p. 
34. NLN accreditation-community nursinl? 
services; guide to preparing a report for 
evaluation for preliminary accreditation. 
New York. National League for Nursing. 
Department of Public Health Nursing, 1966. 
9p. 
35. The planning and organization of 
medical book and journal services in region- 
al hospitals. A National Book League guide 
for librarians. London, Nuffield Provincial 
Hospitals Trust. 1966. 34p. 
36. Principes directeurs de la mise au 
point de programmes dans les maisons d'en- 
seignement. en vue de diplôme en sciences 
infirmières. Ottawa, Association des In fir- 
mières canadiennes, 1966. 12p. 
37. Recommendation jrom the Associa- 
tion of Nurses of Prince Edward Island re- 
garding medical procedures carried out by 
nurses. Fredericton, n.d. 2p. 
38. Seeking foundation funds by David 
M. Church. New York, National Public 
Relations Council of Health and Welfare 
Services, Inc., c1966. 39p. 
39. Statement relative to the national 
labor-management relations act, 1947, May 
7, 1963. New York, American Nurses' As- 
sociation, 1963. lOp. 
40. Statistical data associate degree pro- 
grams in nursing 1966. New York, Natioool 
League for Nursing. Dept. of Associate De- 
gree Programs, 1966, 8p. 
41. Suggested design guidelines for nur- 


FEBRUARY 1967 



fare. Public Health Service. Administrative 
æpects 0/ hospital central medical and surg- 
ical supply senoices. Washington, 1966. 37p. 
48. Dept. of Health, Education and Wel- 
fare. Public Health Service. Estimating the 
cost of illness by Dorothy P. Rice. Washing- 
ton, 1966. 131p. 
49. Dept. of Health, Education and Wel- 
fare. Public Health Service. A manual for 
hospital central medical and surgical supply 
services. Washington, 1966. 106p. 
50. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree- 
ments; arbitration procedures. Washington. 
U.S. Govt. Print. Off., 1966. 167p. 
51. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree- 
ments; management rights and union- 
management co-operation. Washington, U.S. 
Govt. Print. Off., 1966. 69p. 
52. Dept. of Labour. Women's Bureau. 
Handbook on women workers 1960. Wa- 
shington. U.S. Govt. Print. Off., 1960. Iv. 
53. Dept. of Labour. Women's Bureau. 
Nurses and other hospital personnel; their 
earnings and employment conditions. Re- 
printed with supplement. Washington, U.S. 
GOVI. Print. Off., 1961. 41p. 


A.) - Toronto. R 
55. The historical dnelopment of one 
aspect of curriculum development in nursing 
education by Sister Marie Bonin. Washing- 
ton, 1965. Thesis (M.Sc.N.) - 1965. R 
56. Methods of evaluating the senoice of 
professional nursing students in selected 
schools of nursing by Margaret Mary Street, 
Boston, 1961. 105p. Thesis (M.Sc.N.) - 
Boston. R 
57. The preparation of survey schedules 
for the selection of the facilities in three 
Canadian provinces for the organization of 
a collegiate program in nursing by Sister 
Jeanne Forest. Washington, 1945. Thesis 
(M.Sc.N.Ed.) - Catholic Univ. of America. 
108p. R 
58. Relationship between achie
'ement in 
high school and achievement on the exa- 
minations for admission to practice nursing 
in Canada by Sister Claire Jeannatte. Wash- 
ington, 1965. Thesis (M.Sc.N.) - Catholic 
Univ. of America. 44p. R 
59. A study of the educational value 0/ 
a learning experience in a rural hospital 
setting by Sister Marguerite Letourneau. 
Washington, 1963. Thesis (M.Sc.N.) - 
Catholic Univ. of America. 89 p. R 
60. A study of performance on pre-en- 
trance tests and examinations for admission 
10 practice and the relationship between 
these tests by Sister Jeannette Gagnon. 
Washington. 1963. Thesis (M.A.) - Catho- 
lic Univ. of America. 54p. R 


accession list 


sing education facilities; schools of nursing. 
Toronto. Ontario Hospital Services Com- 
mission. 1966. 5p. 
42. Sun'ey of employment conditions of 
nurses employed by physicians and for 
dentists, July 1964. New York, American 
Nurses' Association. Research and Statistics 
Unit, 1965. 24p. 


GOVERNMENT DOCUMENTS 
Canada 
43. Dept. of Labour. Labour-Management 
Co-operation Service. Labour management 
Committee material, order book. Ottawa. 
Queen's Printer, 1966. 3Op. 
44. Dominion Bureau of Statistics. Census 
of Canada 1961. General review. Housing 
in Canada. Ottawa, Queen's Priner, 1966. 
79p. 
45. Parliament. House of Commons. Bill 
C-170; an act respecting employer and em- 
ployee relations in the Public Service of 
Canada. Ottawa. 1966. 53p. 
Nova Scotia 
46. Dept. of Labour. Economics and Re- 
search Division. Wage rates and hours of 
labour in Nova Scotia. Halifax. 1966, 226p. 
United States 
47. Dept. of Health, Education and Wel- 


STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION. 
54. An enquiry into the need lor conti- 
nuing education for registered nurses in 
the prm'ince of Ontario by M. Josephine 
Flaherty. Toronto. 1965. 176p. Thesis (M. 


Request Form 
for "Accession List" 
CANADIAN NURSES' 
ASSOCIATION LIBRARY 


++++++++++ 
++++++++++ 
++
.+++++++ 
++

++++++ 
++++'++++++ 
++++++++++ 
++++++++++ 
+++++ 


Send to: 
LIBRARIAN, Canadian Nurses' Association, 
50 The Driveway, Ottawa 4, Ontario. 
Please lend me the following publications, listed in the 
..... ........ issue of The Canadian Nurse, 
or add my name to the waiting list to receive them when 
available. 
Item Author Short title (for identification) 
No. 


Tums 
consume 
93 times their 
own weight 
in excess 
stomach 
acid! 


Laboratory tests show Tums neu- 
tralize 93 times their own weight 
in excess stomach acids, and that 
they maintain a balanced level for 
long periods, too. Turns go to work 
in 4 seconds on gas, heartburn and 
indigestion. And they taste pleas- 
antly minty, need no water and 
cost so very little. Those are the 
facts. So next time your tummy 
gives you a turn, give Tums a try. 
They're worth their weight in gold ! 
4llO
$.
 


Request for loans will be filled in order of receipt 
Reference and restricted material must be used in the 
CNA library. 
Borrower 


Position 


Address .. 


Date requested .. 


think how fast they'll work 
on your tummy upsets! 
FEBRUARY 1967 


THE CANADIAN NURSE 57 



classified advertisements 


I I 


I 
I 


ALBERTA 


BRITISH COLUMBIA 


NIGHT SUPERVISOR, R.N. AND MEDICAL HEAD 
NURSE for 9O-bed octive treatment hospital in the 
City of Wetoskiwin, situated midway between Ed. 
monton and Red Deer. Residence accommodation 
available, excellent salary ranges and fringe benefits 
in effect, as well as payment for prior experience. 
Apply to: Director of Nursing, Municipal Hospital, 
Wetaskiwin, Alberta. 1.96-1 
Regiltered Nurse. far new SO.bed active treatment 
hospital, situated only 15 miles from Edmonton. 
Salary $360 - $420 per month. Recognition given for 
previous experience Excellent personnel policies and 
working conditions. For further information please 
write to: Miss M. Macintosh, R.N., Director of 
Nursing, Fort Saskatchewan General Hospital, Box 
12 70, fort Sask a tchewan, Alberta. 1-39-2 
Regist.r.d Nurses (5) required (summer relief or per- 
manent posts) for May 1967. The Peace River Municipal 
Hospital, Alberta, was built 5 years ago and has a 
complement of 70 beds. Starting salary for 1966 
$370. New salary scales expected for 1967. Peace 
River is a progressive town and a beauty spot on the 
Prairies. Apply to: The Director of Nursing for fuller 
particulars. Peace River, Municipal Hospital, Peace 
River, Alberta. 1-69-1 
Registered Nunes and Certified Nursing Aides for 
17-bed hospital. Salary for Graduate Nurses basic 
$400 to $460. Certified Nursing Aides $240 to $280 
with credit for previoue experience. Full maintenance 
available at $35 per month. Apply to: Miss A. Nun. 
weiler, Director of Nursing, Oyen Municipal Hospital, 
Oyen, Alberta. Telephone: 664-3 553 1-68-1 
General Duty Nurses (2) for a modern general 30- 
bed hospital. East Central Alberta Highwoy 12. 
Salary according to experience. vearly increments. 
AARN personnel policies. Apply to: Sister Adminis- 
trator, Our Lady of the Rosary Hospital, Castor, 
Alberta. 1-19-1 


ADVERTISING 
RATES 


FOR All 


CLASSIFIED ADVERTISING 


$10.00 for 6 lines or less 
$2.00 for each additional line 


Rates for display 
advertisements on request 


Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 
The Canadian Nurses' Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
In the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses' ASsociation of the 
ProvInce in which they are interested 
in working. 


Address correspondence to: 


The 
Canadian ð 
Nurse v 


50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 


58 THE CANADIAN NURSE 


I I 


ALBERTA 


REGISTERED NURSES fOR GENERAL DUTY (WANTED) 
for a 37-bed General Hospital. Salary $380 - $440 
per month. Commencing with $375 with 1 year and 
$390 with 3 years. practical experience elsewhere. 
Full maintenance available at $35 per month. Pen- 
sion plan available, train fare from any point in 
Canada will be refunded after 1 year emplovment. 
Hospital located in a town of 1,100 population, 85 
miles from Capital City on a paved highway. 
Apply to: Two Hills Municipal Ho.pital, Two Hills, 
Alberta. 1-88-1 


NURSES fOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hat. 
Nurses on staff must be willing and able to take re- 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses' residence with all single rooms situated on 
hospital grounds. Apply to: Mrs. M. Hislop, Adminis- 
trator and Director of Nursing, Bassano General Hos- 
pital, Bassano. Alberta. 1-5-1 


General Duty Nurses for an active accredited well 
equipped 64.bed hospital in a growing town, popu- 
lotion 3,500. Centrally located between maior cities. 
Full maintenance available in a new residence, $35.00 
per month. Alberta Registered Nurses salary $360.00 
- $420.00, commensurate with experience. Excellent 
personnel policies and working conditions. Apply: 
Director of Nursing, Brooks General Hospitol, Brooks, 
Alberta. 1-13-1 A 


GENERAL DUTY NURSES for modern 25-bed hos- 
pital on Highwoy No. 12, East-Central Alberta. 
Salary range $380 to $440. (including a regionol 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronation Municipal Hospital. 
Coronotion, Alberta. Tel.: 578-3803. 1-25-IB 
GENERAL DUTY NURSES for 64-bed, active treatment 
hospital, 35 miles South of Calgary. Salary range 
$360 - $420. Living accommodation available in 
separate residence if desired. Full maintenance in 
residence $35 per month. 30 days paid vacation after 
12 months employment. Please apply to: The Director 
of Nursing, High River Municipal Hospital, H
gh 
River, Alberta. 1-46-1 


GENERAL DUTY NURSES: Modern 26-bed hospital 
close to Edmonton. 3 buses daily. Salary $360.00 to 
$420.00 per month commensurate with experience. 
Residence available $35.00 per month. Excellent 
personnel policies. Apply: Director of Nursing, 
Mayerthorpe Municipal Hospital, Moyerthorpe, Al- 
berta. 1-61-1 


GENERAL DUTY NURSES for 94-bed General Hospital 
located in Alberta's unique Dinosaur Badlands. $360 
- $420 per month, 40 hour week, 31 days vacation, 
pension, Blue Cross, M.S.I. and generous sick time. 
Apply to: Miss M. Hawkes, Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberta. 1-31-2 A 


General Duty Nurses and Certified Nursing Aides for 
modern combined active treatment and Auxiliary 
Hospital. Salary starts at $355 and $240 respectively. 
Liberal personnel policies. accommodation available. 
Located in Southern Alberta close to U. S. boundary 
and Waterton-Glacier International Peace Park. The 
61-bed combined hospital serves the town and area of 
approximately 6,000 population with all services. 
Apply to: The Director of Nursing, Cardston Municipal 
Hospital, Box 310, Cardston, Alberta. 1-17-1 


GENERAL DUTY NURSES (6) and CERTifiED NURS- 
ING AIDES for modern 72-bed hospital. Salary $355 
and $240 respectively; credit for experience; liberal 
policies. Accommodation available. Apply to: Ad- 
ministrator, Providence Hospital, High Prairie, Al- 
berta. 1-45- I 


BRITISH COLUMBIA 


Operating Raam Heod Nurse ($464. $552), Generol 
Duty Nunes (B.C. Registered $405 - $481, non-RegIS- 
tered $390) for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, curling 
and bowling. Hot springs swimming nearby. Nurses' 
residence, room $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36-1 


Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Registered Nur.es (ar tho.. eligible) to apply for 
pOlitions in Medicine, Surgery and Psychiatry. Apply 
to: Director of Nursing. Victoria, British Columbia. 
2.76-4A 


B_C. R.N. far Generol Duty in 32 bed General Hospi- 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefits, modern, comfortable, nurses' residence in 
attractive community close to Vancouver, B.C. For 
application form wtlte: Director of Nursing, Fraser 
Canyon Hos pital, R. R. I, Hope, B.L 2-30.1 
GENERAL DUTY NURSES (Twa) for active 66-bed 
hospital, with new hospital to open in 1968 
Active in-service programme. Salary range $372 to 
$444 per month. Personnel policies according to 
current RNABC contract. Hospital situated in beauti- 
ful East Kootenays of British Columbia, with swim- 
ming, golfing and skiing facilities readily availab:e. 
Apply to: The Director of Nursing, St. Eugene Hos- 
pital, Cranbrook, British Columbia. 2-15-1 
General Duty Nurses for active 3D-bed hospital. 
RNABC policies and schedules in effect, also North- 
ern allowance. Accommodations available in res- 
Idence. Apply: Direc.tor of Nursing, General Hospital, 
fort Nelson, Bntl,h Columbia. 2-23-1 
General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary ond 
personnel policies in accordance with RNABC. Com. 
fortable Nurses' home. Apply: Director of Nursing, 
Boundary Hospital, Grand Forks, British Columbia. 
2-27.2 


General Duty Nurse. (2 immediately) for active. 
26-bed hospital in the heart of the Rocky Mountains, 
90 miles from Banff and Lake Louise. Accommodo- 
tion available in attractive nurses' residence. Apply 
giving full details of training, experience, etc. to: 
Administrator, Windermere District Hospital, Inver- 
mere, Brit ish Columbia. 2-31-1 
General Duty Nurscs for new 37-bed hospital. 
Located in Southwest British Columbia. Salary and 
personnel policies in accordance with RNABC. $390 
to $466. Accommodation available in residence. Apply 
to: Director of Nursing. Nicola Valley General Hos 
pital, Box 129, Merrill, British Columbia. 2-41-1 
Generol Duty Nurses for well-equipped 80.bed Gener- 
al Hospital in beautiful inland Valley adjacent Lake 
v.:athlyn and Hudson Bay Glacier. Initial sa lory $387. 
Maintenance $60, 40 hour 5 day week. vacation with 
pay, comfortable. attractive nurses' residence. 
Sooting, fishing, swimming, golfing, curling, skating, 
skiing. Apply to: Director of Nursing, Bulkley Valley 
District Hospital, P.O. Box No. 370, Smithers, British 
Columbia. 2-67-1 


GENERAL DUTY NURSES Salary - non B.C 
registerea $375 per month - B.L registered $390. 
$466, depending on experience. RNABC policies i" 
effect. Nurses' residence available. Group Medical 
Health Plan. All winter and summer sports. Apply: 
Director of Nursing, Cariboo Memorial Hospital. Wil 
Iiams Lake, British Columbia. 2-80-1 A 


General Duty O. R. and experienced Obstetrical 
Nurses for modern, 150-bed hospital located in the 
beautiful Fraser ValleYa Personnel policies in ac- 
cordance with RNABC. Apply to: Director of Nursing, 
Chilliwack General Hospital, Chilliwack, British Co 
lumbia. 2-13-1 


General Duty and Operating Room Nurses far 70-bed 
Acute General Hospital on Pocific Coast. B.C. Regis 
tered $390 - $466 per month (Credit for experience) 
Non B.L Registered $375 - Practical Nurses B.L LI 
censed $273 - $311 per month. Non Registered $253- 
$286 per month. Board $20 per month, room $5.00 per 
month. 20 paid holidays per year and 10 statutory 
holidays after 1 year. Fare paid from Vancouver. 
Superannuation and medical plans. Apply: Director of 
Nursing. St. George's Hospital, Albert Bay, Britis'" 
Columbia. 2-2-1 A 


General Duty, Operating Room and Experienced 
Obstetricol Nurse. for 434-bed hospital with school 
of nursing. Salary: $372.$444. Credit for post ex- 
perience and postgraduate training. 40.hr. wk. Stat 
utory holidays. Annual increments; cumulative lick 
leave; pension plan; 28-daYI annual vacation; B.C- 
registration required. .Apply: Director. of Nurs.i':lg. 
Royal Columbian Hospital, New Westminster, Bfltll
 
Columbia. 2-73-13 


Groduote Nune. for 31-bed hospital on B.L Coast 
Salary $372 for B. C. Registered Nurses plus $I
 
northern living allowance. Personnel policies in 
accordance with RNABC. Travel from Vancouver 
refunded after 6 mos. Apply: Administrat.jr, General 
Hospital, Ocean falls, British Columbia. 2-49-1 
GRADUATE NURSES for 24.bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel proc- 
tices in accord with RNABC. Accommodation availa. 
ble. Apply: Director of Nursing, General Hospital, 
Squamilh, British Columbia. 2-68.' 


FEBRUARY 1967 



BRITISH COLUMBIA 


General Duty and Op.rating Room Nunes for 
modern 450-bed hospital with School of Nursing. 
RNABC policies in effect. Credit for past experience 
and postgraduate training. British Columbia registra- 
tion required. For particulars write to: the Director of 
Nursing Service, St. Joseph's Hospital, Victoria, British 
Columbia. 2-76-5 


GRADUATE NURSES for busy 21-bed general hospital 
preferably with obstetrical experience. Friendly at- 
mosphere, beautiful beaches, local curl ing club. 
Own room and board $40 month. Basic salary $357 
or $372 plus recognition for post graduate ex- 
perience. Apply Matron, Tofino General Hospital, 
Tofino, Vancouver Island, B_ C 2-71-1 


MANITOBA 


Director 0' Nurs.. for up-fa-date 38-bed hospital. 
New nurses' residence of 196.4 has separate nurses 
suite available. Sick leave, pension plan and other 
fringe benefits available. Personnel policies will be 
sent on request. Enquiries should include experience, 
qualifications and salary expected, and should be 
addressed to: Mr. O. Hamm, Administrator, Altona 
Hospital District No. 24, Box 660, Allona, Manitoba. 
3-1-1 


RegIstered Nurses (2) for 50-bed General Hospital in 
Fort Churchill, Manitoba. Slarting salary $470 per 
month with higher 1967 schedule effective January 1. 
Train fare from Winnipeg refunded after six months 
service, and return fare refunded after one year 
service. Apply to: Director of Nursing. For 
Churchill General Hospital, Fort Churchill, Mani- 
toba. 3-75-1 


Regislered Nurses (2) for 10-bed hospital 01 Fisher 
Branch. Manitoba. Starting salary $400/m. Duties to 
commence as soon as possible. Residence accom- 
modation available. For further information and ap- 
plication forms. apply to: Matron, Fisher Branch 
Hospital, Fisher Branch, Manitoba. 2-23-2 


Registered Nurse' for 18-bed hospital at Vita Manitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
range $380 - $440, with allowance for experience. 
40 hour weeK, 10 statutory holidays, 4 weeks paid 
"acation after one year. Full maintenance available 
for $50 per monlh. Apply: Malron, Vita Districl 
Hospital, Vita, Manitoba. 3-68-1 


Registered Nurses and licensed Practical Nurses for 
232-bed Children's Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: Director of Nursing, Children's Hos- 
pital, Winnipeg 3, Manitoba. 3-72- 1 


Registered Nurse for General Duty in 20-bed hospital. 
Salary range $380 - $440 per month to be increased 
Jan. 1, 1967. Room and board available 01 $55.50 
per month. Generous personnel policies. Full details 
ovailable on request. Apply: Director of Nursing, 
Reston Community Hospital, Reston, Man. 3-46-2 


General Duty Nurses for 100-bed active treatment hos- 
pital. Fully accredited. 50 miles from Winnipeg on 
Trans Canada Highway. Apply: Director of Nursing 
Service. Portage District General Hospital, Portage La 
Prairie, Monitoba. 3-45-1 


NOVA SCOTIA 


REGISTERED NURSES for 53-bed medium and long- 
term active treatment hospital in a progressive city. 
Particulars on request. Apply to: Director of Nursing, 
Holifax Civic Hospital, 5938 University Avenue, Hali- 
fax, Nova Scotia. 6-17-10 A 


Registered Nurse. for 21.bed hospilal in pleasant 
community - Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital. 
Sheet Harbour, Nova Scotia. 6-32- 1 


ONTARIO 


Co-ordinator of Clinical Nursing Studies in the 
Bachelor of Science in Nursing Course: The School 
of Nursing, McMaster University, invites applications 
from persons with advanced qualifications in clinical 
nursing. The position is open for the 1967-1968 
session, with duties commencing July 1967. Please 
apply sending curriculum vitae and two references 
to: Director, School of Nursing, McMaster University, 
Hamilton, Ontario. 7-55-15 


FEBRUARY 1%7 


I I 


ONTARIO 


Registered Nurse, for 34.bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462. 3-wk. vacation with pay; sick leave after 
6-mo. service. All Staff 5 day 4()'hr. wk., 9 
statutory holidays, pension plan and other benefits 
Apply to: Superintendent, Englehart & District Hos 
pital, Englehart, Ontario. 7-40-t 


Registered Nurses. Applications and enquiries are 
invited for general duty positions on the staff of the 
Manitouwadge General Hospital. Excellent so lory 
and fringe benefits. liberal policies regarding ac. 
commodation and vacation. Modern well-equipped 
33-bed hospital in new mining town, about 250-mi. 
east of Port Arthur and north-west of White River, 
Ontario Pop. 3,500. Nurses' residence comprises indiA 
v
dual self-contained opts. Apply, stating qualifica. 
tions, experience, age, marital status, phone number, 
etc. to the Administrator, General Hospital, Mani
 
touwadge, Ontario. Phone 826-3251 7-74-1 A 


Registered Nurses: Applications are invited for Gener 
01 Duty Staff Nurses; Gross salary range: $362 to 
$422. Supervisory advancement opportunities. Resident 
accommodations avaitable; Hospital situated in tourist 
tawn off Lake Huron. For further information write: 
Superintendent, Saugeen Memorial Hospital, South- 
ampton, Ontario. 7-122-1 


Registered Nurses for 35-bed active treatment hospital, 
35 miles north east of Toronto, Ontario. Minimum 
salary $355 per month, and annual increments. Per
 
sonnel policies including, Medical, O.H.S.C.. weekly 
Indemnity Insurance, Ontario Hospital Pension Plan, 
and Group Life Insurance shared by the hospital, plus 
other benefils_ Apply 10: The Superintendent, The 
Collage Hospital (Uxbridge), Uxbridge, Ontano. 
7.135-1 


Registered Nurses for 18-bed (expanding to 36 bed) 
General Hospital in Mining and Resort town of 5,000 
people. Beautifully located on Wawa Lake, 140 miles 
north of Sault Ste. Marie, Ontario. Wide variety of 
summer and winter sports including swimming, boat. 
ing, fishing, golfing, skating, curling and bowling. 
Six churches of different faiths. Salaries comporable 
with all northern hospitals. limited bed and board 
available at reasonable rate. Excellent personnel 
policies, pleasant working conditions. Apply to: 
Director of Nursing, The Lady Dunn General Hospifal, 
Box 179, Wawa, Ontario_ 7-140-1 B 


Registered Nunes and Registered Nursing AsslstanlS. 
for lOO-bed General Hospital, situated in northern 
Ontario. Starting salary, Registered Nurses $390 per 
month. Registered Nursing Assistants $273 per month, 
shift differential, annual increment, 40 hour week. 
O. H. A. pension plan and group life insurance. 
O. H. S_ C. and P. S. I. plans in effect_ Accommoda 
tion available in residence if desired. For full par- 
tkulors apply: The Director of Nurses, Lady Minto 
Hospital, Cochrc.ne, Ontario. 7-30- 1 A 


Registered Nurses and Registered Nursing Assistants 
are invited to make opplicotion to our 75-bed. 
.nodern General Hospital. You wHi be in the Vaca 
tionland of the North, midway between the Lakehead 
and Winnipeg, Manitoba. Basic salories are $371 
and $259, with yearly increments. Write or phone: 
The Director of Nursing, Dryden District General 
Hospital, DRYDEN, Ontario. 7-26-IA 


REGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS (IMMEDIATELY) for a new 40-bed hos- 
pital with nurses' residence. Nurses - minimum salary 
$387 plus experience allowance, 3 semi-annual incre- 
menls of $10 each. R_N.A:s . $270 plus experience 
allowance, 2 onnual increments of $10 each. Reply to: 
The Director of Nursing, Geraldton District Hospital, 
Geraldlon, Ontario. 7-50-1 


Registered Nunes and Registered Nursing Assistants 
for 160-bed accredited hospitaL Starting salary $415 
and $285 respectively with regular annual incre- 
ments for botn. Excellent personnel policies. Resid. 
ence accommodation avo ilable. Apply to: Director of 
Nursing, Kirkland & District Hospilal, Kirkland Lake, 
Ontario. 7-67.1 


Registered Nurses and Registered Nursing Assistants 
for 123-bed accredited hospital. Starting salary $400 
and $255 respectively with regular increments for 
both. Usual fringe benefits. For full information, 
apply to: Director of Nursing, Dufferin Area Hos- 
pital, Orangeville, Ontario. Phone 941-2410_ 7-90-1 


Registered Nurses and Registered Nursing Assistants: 
Applications are invited from R. N's and R. N. Ass'ts. 
who are interested in returning to "nursing at the 
bedside" in a well-equipped General Hospital. Excel. 
lent starting salaries and fringe benefits now. Further 
increase January 1. 1967. Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux Lookout General Hospital, P. O. Box 
909, Sioux Lookout, Ontario. 7-119-1 A 


I I 


ONTARIO 


Registered or Graduate Nurses, required for modern 
92-bed hospital. Residence accommodation $20 month- 
ly. Overseas nurses VI. elcome. lovely old Scottish 
Town near Ottowa. Apply: Director of Nursing, The 
Great War Memorial Hospital, Perth, Ontario. 7-100-2 


Registered Nurses for General Duty in well.equipped 
2B-bed hospital, located in growing gold mining 
and tourist area, north of Kenora, Ontario. Modern 
residence with individual rooms; room, board and 
uniform laundry only $45. 40-hr. wk., no split shift, 
cumularive sick time, 8 statutory holidays and 28 
day paid vacatian after one year. Starting salary 
$400. Apply to: Matron, Margaret Cochenour Memo- 
rial Hospital, Cochenour, Ontario. 7-29-1 


Registered Nurses for General Duty and Operating 
Room, in modern 100.bed hospital, situated 40 miles 
from Ottawa. Excellent personnel policies. Residence 
accommodation available. Apply to: Director of 
Nursing, Smiths Falls Public Hospital, Smiths Falls, 
Ontario. 7-120-2A 


Registered Nurses for General Duty in lOO.bed hos- 
pital, located 3D-mi. from OUawa, are urgently reo 
quired. Good personnel policies, accommodation 
available in new staff residence. Apply: Director of 
Nursing, District Memorial Hospital, Winchester, On 
Iorio. 7-144.1 


Registered Nurses 'or General DUlY and Operating 
Room in modern hospital (opened in 1956). Situated 
in the Nickel Capital of the world, pop. 80,000 
people. Salary $372 per moo, with annual merit 
Increments, plLs annual bonus plan, 40.hr. wk. Recog- 
nition for experience. Good personnel pollcies_ Assist 
once with transportation can be arranged. Apply: 
Director of Nursing, Memorial Hospitol, Sudbury, 
Ontario_ 7-127-4 


General Duty Nurses for 66-bed General Hospital. 
Starting salary: $375/m. Excellent personnel policies. 
Pension plan, hfe insurance, etc., residence accom- 
modation. Only 10 min. from downtown Buffalo. 
Apply: Director of Nursing, Douglas Memorial Hos- 
pital, Fort Erie, Ontorio. 7-45-1 


General Duty Nurses for octive General 77-bed Hos- 
pital in heart of Muskoka lakes area: salary range 
$400 - 5460 with consideration for previous experience; 
excellent personnel policies and fringe benefits:nurses' 
residence availoble. Apply to: Director of Nursing, 
Huntsville District Memorial Hospita), Huntsville, On- 
tario_ 7-59-1 


General Duty Nurses for 100-bed modern hospital. 
Southwestern Ontorio, 32 mi. from London. Salary 
commensurate with experience and ability; $398/m 
basic solary. Pension plan. Apply giving full par- 
ticulars to: The Director of Nurses, District Memorial 
Hospilal, Tillsonburg, Ontario. 7-131-1 


General Duty Nurses, Certified Nursing Assistants & 
Operating Raam Technician (1) for new 50-bed hos. 
Pltal with modern equipment, 40.hr. wk., 8 statutory 
holidays, excellent personnel policies & opportunity 
for advancement. Tourist town on Georgian Bay. 
Good bus connections to Toronto. Apply to: Director 
of Nurses, General Hospital, Meaford, Ontario. 7-79-1 


General Staff Nurse. and Registered Nursing Assis- 
tants are required for a modern, well-equipped General 
Hospital currently expanding to 167 beds. Situated in 
a progressive community in South Western Ontario, 30 
miles from Windsor.Detroit Border. Salary scaled to 
experience and qualifications. Excellent employee 
benefits and working conditions plus an opportunity 
to work in a Patient Centered Nursing Service. Write 
for further information to: Miss Patricia McGee, B. 
Sc.N., Reg.N. Director of Nursing, Leamington District 
Memorial Hospital, Leamington, Ontario. 7-69-1 A 


OPERATING ROOM NURSES (2) for a fully ac- 
credited 70-bed General Hospital. For Operating 
Room Duty. Salary according to experience. Apply 10: 
O.R. Supervisor, penetanguishene General Hospital, 
Penetanguishene, Ontario. 7-99-2 


Public Health Nurses for generalized program. Every 
modern fringe benefit. Full credit for experience. 
Present salary range $5,030 - $6,148. Further, we 
are prepared to give consideration to any salary 
request. Apply to: E. G_ Brown, M.D., D.P.H. Direclor 
and M.O.H., Kent County Health Unit, 21 - 7th. St., 
Chatham, Ontario_ 7-24-4 


PUBLIC HEALTH NURSES (2 QUALIFIED) - Stoff 
positions ovailable in the City of Oshawa. Duties to 
commence January 3rd, 1967. Generalized program 
in an official agency. Salary $5,658 to $6,507. 
8eginning salory according to experience. liberal 
personnel policies and fringe benefits. Apply to: Mr. 
D. Murray, Personnel Officer, City Hall, 50 Centre 
Street, Oshowa, Ontario. 7-92-2 


THE CANADIAN NURSE 59 



NURSE- 
ANESTHETIST -08 


For 350 Bed Commun!ty 
Teaching Hospital, 35 mIn- 
utes from Metropolitan New 
York. 


Excellent Salary 
+ Benefits 


In-service Education 
. . 8 Paid Holidays per year 
. . Tuition Refund Program 
. . 12 Paid Sick Days 
per year 
. . Free Life and 
Disability Insurance 
. . Blue Cross Coverage 


. 


Send Resume to: 


Box CN 1433, 
125 West 41 St. 
New York NY 10036 


An Equal Opportunity 
Employer MfF 


RIVERSIDE 
HOSPITAL 
OF OTTAWA 


A new, air-conditioned 340-bed 
hospital. Applications are called 
for Nurses for the positions of: 


HEAD NURSE - Operating Room 
ASSISTANT HEAD NURSES 
GENERAL STAFF NURSES 
and 
REGISTERED NURSING ASSISTANTS 


Address all enquiries to: 
Director of Nursing 
RIVERSIDE HOSPITAL OF OTT A W A 
1967 Riverside Drive, 
Ottawa, Ontario 


60 THE CANADIAN NURSE 


ONTARIO 


Public Health Nurses for generalized programme in 
a Counly.Cily Health Unil. Salary schedule as of 
January 1, 1967, $5,100 10 $6,100. 20 days vacalion. 
Errp10yer sh":Jred pension plan, P.S.I. and hos;>ital- 
\z":]t:on. Mi1eage allowance or unit cars. Apply to: 
M'S5 Veronica Q'Le:.ry, Sl..pervisor of Public Health 
Nursing, Pele,borough Counly-Cily Heallh Unil, P.O. 
Box 246, Pelerborough, Onlario. 7-101-4A 


PUBLIC HEALTH NURSES for generalized public health 
program. Good personnel policies inciLding .4 weeks' 
vacation, sick time allowance, unit COf or Car allow- 
ance, shared pension plan, hospitalization, and 
group insurance available. Apply to: Mrs. Muriel 
McAvoy, Secretary-Treasurer, Porcupine Health Unit, 
70 Balsam Slreel Soulh, Timmins, Onlario. 7.132-2 


QUEBEC 


EXPO 67, NURSES, BE WISE... Reserve your room 
now for Expo 67. Semi-private rooms for one person 
in a modern home at 10 minutes from Expo grounds. 
Rate:$15 per day, including morning coffee and 
transportation to Expo site. Please write to: Mme 
Marguerile Richard, R.N., 3585, Beaufort, Ville Bros- 
sard. Quèbec. 9-86-3 


GRADUATE NURSE for Privale Camp in Ihe Lauren. 
lions. JULY AND AUGUST 1967. Wrile: PripSlein's 
Camp Inc., 6344 MacDonald Avenue, Monlreal 29, 
Quebec. 9-86-5 


OPERATING ROOM STAFF NURSES: (Applicalions are 
inviled). In a modern 350-bed hospilal. Salaries com- 
mensurate with experience and postgraduate educa. 
tion. Cumulative sick leave, 28 days cnual vacation, 
retirement plan and other liberal fringe benefits. 
Apply: Director of Nursing Service, St. Mcry's Hospital, 
3830 Lacombe Avenue, Monlreal, Quebec. 9-47-39 A 


SASKATCHEWAN 


DIRECTOR OF NURSING for modern 24-bed aClive 
treatment hospital. Graduates in nursing administration 
or with experience will be given preference. Accommo- 
dation available in nurses' residence. Salary schedule 
will be based on Ihe SRNA recommandalions. Apply: 
Mr. R. Holinaty, Administrator, Wakaw Union Hospital, 
Wakaw, Saskalchewan. 1()"131.1 A 


MATRON for Ihe 2()"bed, new, air.condilioned Cabri 
Union Hospilal. Salary according to SRNA schedule. 
Residence accommodation available. Reply to: Mr. K. 
Exner, Secretary-Treasurer, Cabri Union Hospital, Ca- 
bri, Saskalchewan. 1 ()"13-2 


Regislered Nurses (2) wanted immedialely for Ihe 
20-bed, air.conditioned, new hospital. Salary in ac- 
cordance wilh Ihe SRNA schedule. Residence aCcom. 
modation available. Reply to: Mr. K. C. Exner, 
Secretary.Treasurer, Cabri Union Hospital, Cabri, Sas- 
kalchewan. 1()..13-1 


Registered Nurses (2) for modern 30.bed General Hos- 
pilol at 5hellbrook, Sask., 1967 salory $364 - $464 
accommodation available in new residence, rates 
nominal, personnel policies in accordance to SRNA. 
Shellbrook is 27 miles from cily on Allwealher High. 
way, near Waskesiu summer resort. Write the Ad. 
ministrator, Box 70 - Shell brook Union Hospital, 
Shellbrooke, Saskalchewan. 10.118-1 


REGISTERED NURSES for 24-bed aclive treatment hos- 
pilal. Eslablished personnel policies and pension plan. 
Salary range as per SRNA recommendations. Adjust- 
ments to starting solary made for previous experience. 
Residence accommodation available at 543.50 per 
manlh. Apply: Mr.. Z. Johnson, Acting Direclor of 
Nursing, Wakaw Union Hospital, Wakaw, Saskatche. 
Wan. 10.131-1 


Regislered Nursel for Gene,ol Duty (2) in fully 
modern 27.bed hospital. Initial salary $364 per monlh. 
Personnel policies according to Sask. Reg. Nurses' As- 
sociation recommendations. New modern residence, 
excellent working conditions. Duties to commence 
when convenient. Apply to: Superintendent of Nursing 
Services. Kipling Memorial Union Hospital, Kipling, 
Saskalchewan. 1 ()"59-1 


General Duty and Operating Room NUlle., also 
Certified NUlling A.liltan'l for 560-bed University 
Hospital. Salary commensurate with experience and 
preparations. Excellent personnel policies. Excellent 
opportunities to engage in progressive nursing. Ap. 
ply: Director of Personnel, University Hospital, 50s. 
kaloon, Saskalchewan. 10.1 16-4A 


I I 
INSTRUCTORS IN ALL NURSING AREAS required by I 
School of Nursing, Regina, Saskalchewan. Offen 
3 year and 2 year programs. Enrolment 180. Pre- 
ference given to applicants with experience in 
nursing education or nursing service. Degree prefer 
red. Salary as sel by SRNA. Apply to: Direclor, 
School of Nursing, Regina Grey Nun's Hospilal, 
REGINA, Saskatchewan. 10-109-7 


I I 


SASKATCHEWAN 


UNITED STATES 


REGISTERED NURSES - Soulhern California - Op- 
parlunilies available - 368-bed modern haspilal In 
Medical-Surgical, Labor and Delivery, Nursey, Oper- 
ating Room and Intensive and Coronary Care Units. 
Good salary and liberal fringe benefils. Conlinuing 
rnservice education program a Located 10 miles from 
Los Angeles near skiing, swimming, cultural and edu. 
cational facilities. Temporary living accommodations. 
Apply: Direclor of Nursing Service, SainI Joseph 
Hospilal, Burbank, California 91503. 15-5-63 
REGISTERED NURSES needed for rapidly expanding 
general hospital on the beautiful Peninsula neor 
San Francisco. Outstanding policies and benefits, 
including temporary accommodations at low cost, 
health coverage, fully refundable retirement plan, 
liberal shift differentials, no rotation, exceptional 
In-service and orientation programs, unlimited sick 
leave accrual, unlimited vacation accrual, sick leave 
conversion to vacation, tuition reimbursement. Ex- 
cellent salaries based on experience. Contact Person 
nel Administrator, Peninsula Hospital, 1783 EI 
Camino Real, Burlingame, California - 697't1061. 
15-5-201\ 


Regiltered Nurse.. The Los Angeles Counly General 
Hospital has opportunities in all clinical areaS. We 
invite "/Our enquiries about positions available in pre- 
mature nursery, neuro-surgery, pediatrics, operoting 
room and recovery room, as well as general medicol 
or surg ical words. Several speciclty programs are 
planned for 1967. Slarling salary wilh one year's ex- 
perience in an accredited hospital is $591 per month, 
$624 after six manlhs. Addilional pay for a degree_ 
Evening bonus approximalely $60 per monlh. Night 
bonus $50. Living quarters available on hospital 
grounds for 01 leasl 90 days. We will help you wilh 
California Registration. For further information, 
wrile: Mrs. Dorolhy Easley, Box 1311 CN. Los Angeles 
Counly General Hospilal, 1200 Norlh Slale Slreel, Los 
Angeles, California 90033. 15-5-3 E 
REGISTERED NURSES Opporlunilies available 01 
415-bed hospilal in Medical-Surgical, Labor and 
Del ivery, I ntensive Care, Operating Room and Psv- 
chictl y. No rotation of shift, good salary, evening 
and night differentials, liberal fringe benefits 
Temporary living accommodations available. Apply: 
Miss. Dolores Merrell, R.N., Personnel Director, Queen 
of Angels Hospilal, 2301 Bellevue Aevnue, Los 
Angeles 26, California. 15-5-3G 
REGISTERED NURSES - SAN FRANCISCO Children's 
Hospilal and Adull Medical Cenler hospilal for men 
women and children. California registration required 
Opportunities in all clinical areas. Excellent salaries. 
differentials for evenings and nights. Holidays, vaca- 
tions, sick leave, life insurance, health insurance ond 
employer-paid pension-plan. Applications and details 
furnished on request. Contact Personnel Director, Chil- 
dren's Hospital, 3700 California Street, San Francisco 
18, California_ 15-5-4 


RED CROSS 
IS ALWAYS THERE 
WITH YOUR HELP 


FEBRUARY 1967 



UNITED STATES 


.tegilt.red Nur..., Career satisfaction, interest and 
;,rofessional growth unl imited in modern, JCAH. ce- 
.redited 243-bed hospital. Located in one of Cahfor- 
'lia's finest areas, recreational, educational and cul- 
tural advantages are yours as well as wonderful 
year-round climate. If this combination is what 
iou're looking for, contact us now!Staff nurse en- 
trance salary above $500 per monthi increases to 
$663 per month; supervisory positions at highest 
rates. Special area and shift differentials to $50 per 
month paid. Excellent benefits include free health 
and life insurance retirement, credit union and liberal 
personnel policies. Professional staff appointments 
available in all clinical areas to those eligible for 
California licensure. Write today: Director of Nursing. 
Eden Hospital. 20103 Lake Chabot Road, Castro VaI- 
leI', California. 15.5-12 


REGISTERED NURSES: Mount Zion Hospital and Me- 
dical Center'. increased salary scales now double our 
attraction for nurses who find they can afford to live 
6;Jy the Golden Gate. Expansion has created vacQnc
es 
for staff and specialty assignments. Address enquiry 
to: Personnel Department, 1600 Divisadero Street. San 
Francisco, Cal ifornia 9411 S. An equal opportunity em- 
ployer. 15.5.4 C 


Regi.tered Nurse. for 303-bed modern hospital. Po. 
sitlons available - All services, no .hift rotation. 
Liberal benefits, advancement opportunities, educa- 


ONTARIO HYDRO 


requires 


REGISTERED NURSE 


with 


Public Heolth Nursing Cerfificafe. Inferest- 
ing and responsible position locofed in 
Norfhern Ontario Hydro Colony. 


For further details please 
write to: 


Nursing Supervisor 
ONTARIO HYDRO 
620 University Avenue 
Toronto 2, Ontario 


SCHOOL OF NURSING 
PLUMMER MEMORIAL PUBLIC 
HOSPITAL 


SAULT STE. MARIE, ONTARIO 


Invites applicants for: 
1. Medical-Surgical Instructor 
2. Medical Instructor 
250-bed non-sectorian General Hospital 
with enrolment of BO students. Salary 
commensurote with qualifications. 


Apply to: 
Principal, 
SCHOOL OF NURSING. 


:EBRUARY 1967 


I I 


I I 


UNITED STATES 


UNITED STATES 


tional opportunities in area. equal opportunity 
employer. Apply: Director of Nursing Service. Kaiser 
Foundation Hospitals. San Francisco 15, California. 
Phone (JO 7.4400) 15.5-57 


hours from Lake Tahoe. Starting salary $51O/m. 
with differentials. Apply: Director of Nunes, Mem- 
orial Hospital, Woodland, California. 15-5-498 


Wanted - General Duty Nur.el. Applications now 
being taken for nursing positions in a new addi- 
tion to the existing hospital including surgery, cen- 
tral sterile and supply, general duty. Salary $425 
per month plus fringe benefits. Contact: Director of 
Nurses, Alamosa Community Hospital Alamosa, 
Colorado. 15-6-1 


Regiltered Nursel - California. Expanding, accredit. 
ed 303.bed hospital in medical center of Southern 
California. University city. Mountain ocean resort 
area. Ideal year-round climate, smog free. Starting 
salary $6,300. With experience, $6,600. fringe bene- 
fits, shif, differential, initial housing ollowance. 
Wide variety rentals available. For details on Cali- 
fornia License and Visa, write: Director of Nursing, 
Cottage Hospitol, 320 W. Pueblo Street, Santa Bar- 
bara, California 93105. 15-5-39 A 


STAff NURSES: Needed to staff present fully accredit. 
ed hospital and new facility to open December 1967. 
All services and shifts available. Good salaries and 
fringe benefits. Will pay transportation to and from. 
Minimum one year contract. For particulars concerning 
hospital and community write: L. E. Thompson, Ad- 
ministrator, or V. Jenkins, Director of Nursing, Scioto 
Memorial Hospitol, Portsmouth, Ohio. 15.364 


REGISTERED NURSES - General Duty for 84-bed 
JCAH hospital 1 1 a houri from San Francisco, 2 


WI! 
.
::I

""'d::, 



 
I!
 

"'

:[i
 


BOX 1311 C 
DOROTHY EASLEY, R.N. - Nurse Recruitment Officer 
1200 North State Street 
Los Angeles, Californio 90033 
Telephone 213 225-3115 


Are you looking for career nursing opportunities? 
Do you want more training? 
Do unusual services appeal to you? 


Then you will want 
more information about our hospital 


We are a university teaching hospital 
for two schools of medicine. 


We have over 200 internes, 300 residents 
and a full time medical staff. 


We are one of the world's 
largest medical centers. 


Starting Salary-$560.00/ month 
. Credit for degree 
. Shift differential 
. Credit for experience 


Outstanding Promotional Opportunities 


Assistant Head Nurse or Charge Nurse 
Head Nurs.e 
Clinical Specialist; Teaching Assistant; Instructor 


Coronary Care Unit; P.AR., Intensive Care Units; 
Chest Surgery; Jail; Premature Center; Admitting; 
General Medicine; O.R.; Diabetic Service; Neurosurgery; 
Metabolic Research; Dermatology; Orthopedics; Eye; Rehab; 


You name it - We have it I 


THE CANADIAN NURSE 61 



UNITED STATES 


G.n.ral Duty Staff Nur... for 450.bed fully approved 
teaching hospital. Top salaries with differential for 
evening and night duty. High increments. 4Q-hour 
week, paid vacation based on length of service, 8 paid 
holidays per year. Accumulative sick plan. Com. 
prehensive hospitalization plan. Excellent pension 
plan. Orientation and dynamic inservice program. 
Nurses' Association (A.F.L.) governs hours, salaries 
and working conditions. Registration ta work in 
California required. Address applications to: Chief 
Nurse, Southern Pacific Memorial Hospital, 1400 Fell 
Street. Son francisco. California 94117. 15.5-6 D 


ATTENTION GENERAL DUTY NURSES. 297-bed fully 
accredited County Hospital located 2 hrs. drive from 
San Francisco, ocean beaches, and mountain resorts in 
modern and progressive city of 40.000. 40 hr. 5 
day wk., pd. vocation, pd. holidays, pd. sick leave, 
retirement plan, social security, and insurance plan. 
Accommodations in Nurses' Home, meals at reasonable 
rates. uniforms laundered without charge. Stort $530 
to $556 mo. depending on experience plus .hift and 
service differentials. Merit increases to $644 mo. Must 
be eligible for Calif. Registration. Write Director of 
Nursing. Stanislaus County Hospital. 830 Scenic 
Drive, Modesto, California. 15-5-42 B 
Nurs.. for new 75-bed General Hospital. Re.ort 
area. Ideal climate. On beautiful Pacific ocean. 
Apply to: Director of Nur.... South Coast Com- 
munity Hospital. South Laguna, California. 15-5-50 


I I 


UNITED STATES 


Stoff Duty pa.itian. (Nur...) in private 403-bed 
hospital. Liberal personnel policies and salary. Sub. 
stantial differential for evening and night duty. 
Write: Personnel Director, Hospital of The Good 
Samaritan. 1212 Shatto Street. Los Angeles ] 7, 
California_ 15-5-31> 


NURSE TEAM LEADER POSITIONS in new 372-bed, 
fully accredited. General Hospital in resort area. $461 
p.r month days and $485 per month evening and 
night shift. Liberal fringe benefits. For descriptive bro- 
chure and pol icies write: L. Sims, North Miami Gene- 
ral Hospital. 1701 NE t27th Street. North Miami. 
florida. 15-10-2 A 


REGtSTERED NURSES: for 75-bed air conditioned 
hospital, growing community. Starting salary $330- 
S365/m, fringe benefits, vacation, sick leave, holi- 
days, lif. insurance, hospitalization. 1 meal furnish- 
ed. Write: Administrator, Hendry General Hospital, 
Clewiston. florida. J 5-10-1 


G.n.ral Duty Nur.e. - Pre.ent hospital 55-bed. 
with new 75-bed ho.pital to oper. April. I, 1965. 
Located on Lak. Okeechobee near west Palm Beach. 
Liberal personnel policies, 40-hr. wk., bonus at end 
of fir.t year. Minimum starting salary $380. with 
differential for evenings and nights. Apply: Director 
of Nursing Service. Glade. G.neral Hospital. P.O. 
Box 928. Bell. Glade. florida. 15-10-3 


" 


NIGHT NURSE? 


University Hospital is pleased to announce that starting pay for night 
nurses now ranges from $30.00 to $33.00 per shift ($7,830 to $8,613 
for an annual starting salary)-depending on education and experience. 
After 4 years service, night nurse salaries range up to $9,396.00 
per year. The base pay for permanent evening and rotating tours 
has also been increased plus excellent University Staff benefits are 
offered to all nurses. 
University Hospital has a Service Department which assigns trained 
personnel to handle paperwork and other non-nursing chores, 
relieving our nurses for patient care exclusively. 
Ann Arbor is nationally known as a Center of Culture with emphasis on 
art, music and drama-and recognized as an exciting and desirable 
community in which to live. 
Write to Mr. George A. Higgins, A6001, University Hospital, 
University of Michigan Medical Center, Ann Arbor, Michigan for 
more information, or phone collect (313) 764.2172. 
We are an Equal Opportunity Employer 


UNIVERSITY OF 
MEDICAL CENTER. 


MICHIGAN 
ANN ARBOR 


62 THE CANADIAN NURSE 


NURSES. Regi.tered, for modern 360-bed hospital. 
Op
nings available in all areas, medicine-surgery, 
delivery room, nursery, and postpartum. Near Wayne 
State University, and an integral part of the new 
Medical Center. Salary $550 to $635 per month 
plus differential for afternoon and night. Premium 
pay for weekends. Good fringe benefits including 
Blue Cross and Life Insurance. Apply: Personnel 
Director, Hutzel Hospital formerly Woman's Hospital), 
432 East Hancock. Detroit, Michigan 48201. 15-23-1 f 


OPERATING ROOM NURSE 


Preference given posfgraduofe and! or ex- 
tensive fraining. 


for 270 bed ocufe General Hospitol in the 
interior of British Columbio. 


Apply to: 
Director of Nursing 
ROYAL INLAND HOSPITAL 
Kamloopsr B. C. 


DIRECTOR OF NURSING 


The Solem Chrisfion Sanitorium Associo- 
fion Inc.. which pions to open if's 3Q-bed 
privote Psychiatric Hospital near Toronto 
in 1968. invifes opplicofions for the obove 
posifion. Appoinfmenf will be mode short- 
ly to allow Director fo porficipote in 
planning ond to toke speciol training if 
odvisoble. 


Apply to: 
Rev. J. VanHarmelen r 
Box 33, R.R. No. 2r 
Whitby, Ontario. 


REGISTERED NURSES 


For 011 services including Operofing ond 
Delivery Room. 


Hospifol ropidly exponding fo 450 bed.. 
Solory $502 to $590 wifh shift, week-end 
ond Chorge Nurse differentiol. 


Write to Nursing Ollice 


ST. JOHN HOSPITAL 
22101 Moross Road 
Detroit, Michigan 48236 
or Telephone: 881-8200 
(4-11.24) 


FEBRUARY 1967 



I II 
OPPORTUNITY FOR 


GROWTH 
CHANGE 
SPECIALIZA TION 


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TORONTO GENERAL HOSPITAL 


Large centrally located University Teaching Hospital 


. CONTINUE YOUR PROFESSIONAL GROWTH 
Planned orientation programme 
Continuing in-service programmes 
OpportunitIes of a research and teaching hospital 


. BROADEN EXPERIENCE 
Posifians available: 
General medicine - Obstetrics - Operating Room 
General Surgery - Gynaecology - Recovery Room 
Specialty units and intensive care - Cardiovascular 
Respiratory.- Neurosurgery 


. ENJOY ADVANTAGES OF LIBERAL PERSONNEL POLICIES 
Excellent patient core facililres 
Salaries ICaled to qualifications and experience 
3 weeks vocation, statutory holIdays. cumulative sick leave 
-. Life Insurance, hospitalization, retirement programme 
- Umfarms laundered free 


REGISTERED NURSES 


Lutheran General Hospital, Park Ridge, Illinois is a 
new 587-bed General Hospital, located in a pleasant 
suburb of Chicago. 
The hospital is modern with a wide range of services 
to patients, including Hyperbaric Oxygen Unit. Low- 
cost modern housing next to the hospital is available. 
The hospital is completely air-conditioned. 
Annual beginning salary is from $6,000 plus shift 
differential pay. Regular salary increments at six 
months of service and yearly thereafter. Sick leave 
and other fringe benefits are also available. 


Write or call collect: 


Director of Nursing Services 


LUTHERAN GENERAL HOSPITAL 
PARK RIDGE r ILLINOIS 60068 
Telephone: 692-2210 Ext. 211 
Area Code: 312 


:EBRUARY 1967 


For additional information, write: 


Director of Nursing 
TORONTO GENERAL HOSPITAL 
101 College Street, Toronto 2, Ontario 


t 


II 


SCARBOROUGH CENTENARY HOSPITAL 



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Invites Applications For: 
- ASSISTANT DIRECTOR 
OF ADMINISTRATIVE NURSING 
- SUPERVISORS OF CLINICAL AREAS 
-0. R. SUPERVISOR 
- CASEROOM AND EMERGENCY STAFF 
This modern 750-bed hospifal, scheduled to open in the Summer of 
1967, is fully equipped with the latesf facilities to assist personnel 
in patient care and embraces the most m
ern concepts 
f team 
nursing. Excellent personnel policies are avaIlable. Progres.Slve staff 
and managemenf development programs offer th
 maxImum op- 
portunities for those who are inferested. Salary IS commensurate 
with experience and ability. 
For further information, please direct your enquiries to: 
Director of Nursing Service, 
SCARBOROUGH CENTENARY HOSPITAL 
Post Office Box 250, West Hill, Ontario 


THE CANADIAN NURSE 63 



OSHA W A 
GENERAL HOSPITAL 


GENERAL DUTY NURSES FOR 
ALL DEPARTMENTS 


Starting salary for Ontario Regis- 
tered nurses $400 with 5 annual 
increments to $480 per month. 
Credit for acceptable previous 
service - one increase for two 
years, two increases for four or 
more years. 
Non-registered - $360.00 
Rotating periods of duty - 3 
weeks vacation - 8 statutory 
holidays. 
One day's sick credit per month 
beginning in the 7th month of 
service cumulative to 45 days. 
Pension Plan and Group Life 
Insurance - Hospital pays 50% 
of Medical, Blue Cross and Hos- 
pital Insurance premiums. 
Apply to: 
Director of Nursing 
OSHAWA GENERAL HOSPITAL 
Oshawa, Ontario 


ST. JOSEPH'S 
HOSPIT AL 
HAMIL TON. 
ONTARIO 


A modern, progressive hospital, 
located in the centre of Ontario's 
Golden Horseshoe- 
invites applications for 
GENERAL STAFF 
NURSES 


and 
REGISTERED 
NURSING ASSISTANTS 


Immediate openings are avail- 
able in Operating Room, Psy- 
chiatry, Intensive Care - Coro- 
nary Monitor Unit, Obstetrics, 
Medical, Surgical and Paediatrics. 
For further information write to: 
THE DIRECTOR OF NURSING 
ST. JOSEPH'S HOSPIT At 


Hamilton, Ontario 


64 THE CANADIAN NURSE 


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UNIVERSITY OF ALBERTA 
SCHOOL OF NURSING 


Invites applications 
for instructors in: 
· Medical-Surgical Nursing 
· Paediatric Nursing 
for four-year basic degree 
programme 
and 
· Nursing Service Administration 
for post-basic degree programme 
Effective date of employment: 
July, 1967 
Salary in accord with University af Alber- 
ta salary schedule and commensurate 
with qualificafians and experience. Mas- 
ter's degree or higher preferred. 


Apply to: 
RUTH E. McCLURE 
DIRECTOR, 
SCHOOL OF NURSING 
UNIVERSITY OF ALBERTA 
EDMONTON, ALBERTA 


STAFF NURSE POSITIONS 
Salary Range $482-$620 


with maximum starting $539 on day shift, 
$592 evening and/ar night shiffs. Credit 
given for educatian and/or experience. 
Opportunity fo gain knowledge and skill 
in a specialized cancer research hospital. 
Regisfration in Texas required. Excellenf 
personnel benefifs include: 3 weeks vaca- 
tion, halidoys. cumulafive sick leave. 
laundry of uniforms furnished. refirement 
and Social Securify programs, Hospitaliza- 
tian, life and Disabilify Income Insurance 
available. Equal opportunity employer. 


For applicatian and additional informatian 
Write ta: 


Personnel Manager 


THE UNIVERSITY OF TEXAS 
M.D. ANDERSON HOSPITAL AND 
TUMOR INSTITUTE 


Texas Medical Center 
Houston, Texas 77025 


ASSISTANT DIRECTOR 
OF NURSING 


Applications are invited for the 
above position in a fully ac- 
credited 163-bed General Hos- 
pital in beautiful Northern On- 
tario. 


Desirable qualifications should 
include B.S.N. Degree with ex- 
perience in supervision. 


For further information, 
Write to: 


Director of Nursing 


KIRKLAND and DISTRICT HOSPITAL 


Kirkland Lake, Ontario. 


ONTARIO SOCIETY 
FOR 
CRIPPLED CHILDREN 
requires 
. Camp Directors 
· General Staff Nurses 
. Registered Nursing Assistants 
for 
FIVE SUMMER CAMPS 
located near 
OTTAWA COLLINGWOOD 
LONDON - PORT COLBORNE 
KIRKLAND LAKE 
Applicafians are invifed from nurse.s in- 
ferested in the rehabilitation of physically 
handicapped children. Preference given ta 
CAMP DIRECTOR applicants having super- 
visary experience and ta NURSING ap- 
plicants wifh paediatric experience 


Apply in writing to: 
Miss HELEN WALLACE, Reg. N., 
Supervisor of Camps, 
350 Rumsey Road, 
Toronto 17, Ontario 


FEBRUARY 1%7 



... 


This 


. 
IS a 


little Eskimo boy 


Sometime during the next year. 
he might fall and hurt himself- 
or get measles or pneumonia. 


.. 


He will need the care of a nurse. 


.. 


A good nurse. 


Maybe you? 


Registered hospital and public health nurses, certified nursing assistants, 
lor lurther inlormation write to: 
MEDICAL SERVICES, DEPARTMENT OF NATIONAL HEALTH AND WELFARE, OTTAWA, CANADA. 


DIRECTOR OF NURSING 


Applications are invited 
lor the 


POSITION OF DIRECTOR OF NURSING 


The Director of Nursing will be responsible for 
the administration of all nursing services within 
the hospital. The hospital currently operates 
375 beds and is undergoing extensive moderni- 
zation and expansion costing $3,750,000. There 
is a furnished apartment available at a mini- 
mum rental. A 140 student School of Nursing 
housed in a modern residence and operated 
by the hospital is the responsibility of a Director 
of Nursing Education. 


Address enquiries to: 


DOUGLAS M. McNABB, Administrator 


McKELLAR GENERAL HOSPITAL 


Fort William, Ontario 


FEBRUARY 1967 



 
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THE SCARBOROUGH 
GENERAL HOSPITAL 


Invites applications from General Duty Nurses. 
Excellent personnel policies. An active and stimulat- 
ing In-Service Education and Orientation Programme. 
A modern Management Training Programme to as- 
sist the career-minded nurse to assume managerial 
positions. Salary is commensurate with experience 
and ability. We encourage you to take advantage 
of the opportunities offered in this new and expand- 
ing hospital. 


For lurther inlormation write to: 
Director of Nursing 
SCARBOROUGH GENERAL HOSPITAL 
Scarborough, Ontario 


THE CANADIAN NURSE 65 



THE HOSPITAL 


FOR 


SICK CHILDREN 


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OFFERS: 


I. Satisfying experience. 


2. Stimulating and friendly en- 
vironment. 


3. Orientation and In-Service 
Education Program. 


4. Sound Personnel Policies 


5. liberal vacation. 


APPLICATIONS FOR REGISTERED 
NURSING ASSISTANTS INVITED 


For detailed information 
please write to: 


The Assistant Director 
of Nursing 
AUXILIARY STAFF 


555 University Avenue 
Toronto, Ontario, Canada 


66 THE CANADIAN NURSE 


HUMBER MEMORIAL HOSPITAL 


HOSPIT AL - 
Newly expanded 350-bed hospital. Progressive patient care con- 
cept. 


SALARY - 
General Staff Nurses (Currently Registered in Ontario) $400.00 - 
$480. - 5-increments. 
Registered Nursing Assistants (Currently Registered in Ontario) 
$295.00 - $331.00, - 3 increments. 
HOUSING - 
Furnished apartments available at subsidized rates. 


JOB SATISFACTION - 
High quality patient care and friendly working environment. We 
appreciate our personnel and encourage their professional develop- 
ment. 


You are invited to enquire concerning employment opportunities to: 
Director of Nursing 


HUMBER MEMORIAL HOSPITAL 


200 Church Street, Weston, Ontario 
Telephone 249-8111 (Toronto) 


CALGARY GENERAL HOSPITAL 


requires immediately 


REGISTERED GENERAL DUTY NURSES 


This is a modern 1,000-bed hospital including a new 
200-bed convalescent-rehabilitation section. Benefits 
include Pension Plan, sick leave, and shift differen- 
tial plus a liberal vacation policy and salary range 
$360 - $420 per month commensurate with training 
and experience. 


Apply to: 


Director of Nursing Service 


CALGARY GENERAL HOSPITAL 


Calgary, Alberta 


FEBRUARY 1967 



What does 
Methodist Hospital 
have to offer me? 


At the Methodist Hospital, where research is a part 
of progress, a nursing career takes on new horizons - 
rich in meaning and professional satisfaction. 
If you're looking for the chance to be the nurse 
you've always dreamed of - coming to the world 
famous Methodist Hospital can be an adventure - 
almost like stepping into the future - splendid 
facilities, so much advance equipment and 
everywhere the newest medical and patient care 
techniques are in use. 
Some of the best aspects of nursing at METHODIST 
are as old as medicine itself - there is a spirit of 
kindness and consideration, and emphasis on patient 
care, that make this a hospital where nursing is 
satisfying and rewarding, day by day. 
Methodist Hospital is right in the center of the world's 
great Medical, Research and Educational complexes. 
HOUSTON is an exciting city - rodeo and opera, 
pro.football and the famous Alley Theatre, water sports 
and beaches an hour or less away, the Houston 
Symphony and the Astrodome! 


A Few Quick Facts: We're affiliated with Baylor 
University College of Medicine and associated with 
Texas Woman's University College of Nursing. 
New $9'f.! million Cardiovascular and Orthopedic 
Research Center will open soon. Our Inservice 
Education Department gives you thorough 
orientation, and continued instruction in new 
concepts and techniques. You'll find every 
encouragement to broaden your skills, 
including tuition assistance in obtaining 
further education in nursing. 


... 


Send for Your Colorful Informative Illustrated 
Brochure. . . to learn about Methodist Hospital, 
Houston, positions available, salary and employment 
benefits, tuition allowance, complimentary room 
accommodation and our Nurse Specialist Programs. 
Write, call or send coupon, Director of Personnel, 
The Methodist Hospital, Texas Medical Center, 
Houston, Texas 77025 


....j 


r-------------------------------------ì 
I Director of Personnel, THE METHODIST HOSPITAL, Texas Medical Center, Houston, Texas 77025 I 
I Please send me your brochure about nursing opportunities at THE METHODIST HOSPITAL-Texas Medical Center I 
I I 
I Name I \ 
I Address I 
I I 
I City State Zip Code I 
L_____________________________________ 


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UNIVERSITY 
OF ALBERTA 
HOSPITAL 


Positions are available in our 
rapidly expanding Medical Cen- 
tre situated on a growing Uni- 
versity campus. All service in- 
cluding renal dialysis, coronary 
intensive care and cardiac surg- 
ery offer opportunities for ad- 
vancement. 


Apply to: 
Director of Nursing 
UNIVERSITY OF ALBERTA 
HOSPITAL 
Edmonton, Alberta 


REGISTERED NURSES 


for General Duly 


In modern 20-bed hospital locat- 
ed in thriving northwestern On- 
tario community. Starting salary 
$335 minimum to $400 maxi- 
mum for three years' experience. 
Board and room in modern 
nurses' residence is supplied at 
no charge. Excellent employee 
benefits and recreational facili- 
ties available. Further particulars 
on request. Apply giving full 
details of experience, age, avail- 
ability, etc. to: 


Employment Supervisor 


MARATHON CORPORATION 
OF CANADA LIMITED 


EBRUARY 1967 


Marathon, Ontario 


OPERATING ROOM 
SUPERVISOR 


Required for 270-bed General 
Hospital with construction of a 
new hospital due to completion 
in 1967, increasing the bed ca- 
pacity to 450. Included in the 
new hospital will be the most 
modern operating room complex 
based on the Friesen Concept of 
material and equipment supply. 
Excellent fringe benefits with 
generous sick leave, four weeks 
vacation and contributory pen- 
sion plan. 


For further information write: 
Director of Nursing Service 
BELLEVILLE GENERAL HOSPITAL 
Belleville, Ontario. 


THE CANADIAN NURSE 67 



ONTARIO soclm 


FOR 


CRIPPLED CHILDREN 


I \ 
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Invites applications from Public 
Health Nurses who have at least 
2 years experience in general- 
ized public health nursing, pre- 
ferably in Ontario. 


INTERESTING AND VARIED 
PROFESSIONAL SERVICES 
IN AN EXPANDING PROGRAM 
INCLUDE: 


. an opportunity to work direct- 
ly with children, their parents, 
health and welfare agencies, 
and professional groups 


. participation in arranging 
diagnostic and consultant cli- 
nics 


. assessing the needs of the 
individually handicapped child 
in relation to services provided 
by Easter Seal Clubs and the 
Society. 


Attractive salary schedule with 
excellent benefits. Car provided. 
Pre-service preparation with sa- 
lary. 


Apply in writing to: 


Director, Nursing Service, 
350 Rumsey Road, 
Toronto 17, Ontario 


68 THE CANADIAN NURSE 


Registered Nurses 


AND 


Registered 
Nursing Assistants 


For 300-bed Accredited General 
Hospital situated in the pictur- 
esque Grand River Valley. 60 
miles from Toronto. 


Modern well-equipped hospital 
providing quality nursing care. 
Excellent personnel policie5. 


For further information write: 
Director of Nursing Service 
SOUTH WATERLOO 
MEMORIAL HOSPITAL 
Galt, Ontario 


REGISTERED NURSES 


250-bed General Hospital, ex- 
panding to 400, located in San 
Francisco, California. Positions on 
all shifts for nurses in Intensive 
Care Unit, Operating Room, and 
General Staff Duty. Salary range 
effective April 1967, $600-$700. 
Health and life Insurance, Retire- 
ment Program - all hospital 
paid. liberal holiday and vaca- 
tion benefits. Accredited medical 
residencies in Medicine, General 
Surgery, Neuro Surgery, Ortho- 
pedics, and Plastic Surgery. 


For further information write to: 


Miss Lois Jann, 
Director of Nursing 


FRANKLIN HOSPITAL 


14th and Noe Streets, 
San Francisco, California 


THE 
NORTHWESTERN 
GENERAL 
HOSPIT AL 


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THE HOSPITAL- 
Fully accrediled 
Progressive 150 bed hospital 
Planned expansion to 400 beds 
10 minutes to downtown Toronto. 


YOUR PROFESSIONAL GROWTH 
Planned orientation programme 
Continuing inservice education. 


BENEFITS INCLUDE- 
3 weeks vacation 
8 slatutory holidays 
Cumulalive sick leave 
Group life insurance 
Hospitalization 
40 hour week. 


HOUSING - 
Furnished apartmenls al reduced rates 


For information contact: 
Director of Nursing 


NORTHWESTERN 
GENERAL HOSPITAL 
2175 Keele St., 
Toronto 15, Onto 


FEBRUARY 196" 



PALO ALTO-STANFORD 
HOSPITAL CENTER 


Located on the beautiful campus of Stanford University in Palo Alto, California. 


, 


, 


, 
-- 


., 


-- 


"We invite you to join our professional staff and to gam unparalled experiences m 
nursing." 


For additional information- 
NAME: 
ADDRESS: 
CITY: 
SERVICE DESIRED: 
Return to: PALO ALTO-STANFORD HOSPITAL CENTER 
Personnel Department 
300 Pasteur Drive 
Palo Alto, California 


STATE: 


REGISTE RED NURSES 
REGISTERED NURSING 
ASSIST ANTS 


REQUIRED FOR 


ST. MARY'S HOSPITAL 
TIMMINS, ONTARIO 
MODERN - 200 BED HOSPITAL 
EXCELLENT PERSONNEL POLICIES 
PLEASANT TOWN OF 30.000 
WIDE VARIETY OF SUMMER 
AND WINTER SPORTS - 
SWIMMING, BOATING, 
FISHING. GOLFING, SKATING, 
CURLING, TOBOGGANING, 
SKIING AND ICE FISHING. 


Apply to: 
Director of Nursing Service 
ST. MARY'S HOSPITAL 


Timmins, Ontario 


EBRUARY 1967 


VICTORIA HOSPIT At 


LONDON. ONTARIO 


Modern 1.000-bed hospital 
Requires 
Registered Nurses for 
all services 
and 


Registered 
Nursing Assistants 


40 hour week - Pension plan 
- Good salaries and Personnel 
Policies. 


Apply: 


Director of Nursing 


VICTORIA HOSPIT At 


London, Onto 


ST. JOSEPH'S HOSPITAL 


TORONTO, ONTARIO 


REGISTERED NURSES 
and 
REGISTERED 
NURSING ASSISTANTS 


lOO-bed fully accredited hospital provides 
experience in Operating Room. Recovery 
Room, Infensive Care Unit. Pediatrics 
Orthopedics, Obstetrics. General Surgery 
and Medicine. 
Orientation and Active Inservice program 
for all staff. 


Salary is commensurote with preporafion 
and experience. 
Benefits include Canada Pension Pion, 
Hospital Pension Plan, Group Life Insu- 
rance. Sick leave - 12 days after One 
year, Onfario Hospital Insuronce - 50% 
payment by hospital. 
Rotafing Periods of duty - 40 hour week, 
8 statufory holidays - annual vocotion 
3 weeks after one yeor_ 


Apply: 


Assistant Director of 
Nursing Service 


ST. JOSEPHrS HOSPITAL 


30 The Queensway 
Toronto 3, Ontario 


THE CANADIAN NURSE 69 



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YORK COUNTY HOSPITAL 


NEWMARKET. ONTARIO 


HOSPITAL: 
A newly expanded 257 bed hospital wifh such progressive 
patient care concepts as a 12-bed LCU., 22.bed psychiatric 
ond 24-bed self care unif. 
IDEAL LOCATION: 
45 minutes from downtown Toronfo, 15-30 minutes from 
excellenf summer ond winfer resort oreas. 
SALARIES: 
Registered Nurses: $372-$447 per month. 
Registered Nursing Assistants: $277-$310 per month. 
BENEFITS INCLUDE: 
Furnished apartments, medical and hospital insurance. group 
life insurance. pension plan, 40 hour week. 


Please address all enquiries to: 
Director of Nursing 
YORK COUNTY HOSPITAL 
596 Davis Drive 
Newmarket, Ontario 


ADDITIONAL CLINICAL TEACHERS 


required 


to assist in Developing New Curriculum and a 
Regional School. 
School of Nursing Building is New 
and well equiped. 
Salaries and Fringe Benefits at Metropolitan level. 
Qualifications - B.Sc.N. 


or 
Diploma in Nursing Education 


GENERAL STAFF NURSES 


Required for all Services 
Salaries and Fringe Benefits at Metropolitan level 


Apply to: 
DIRECTOR OF NURSING 
BRANTFORD GENERAL HOSPITAL 


Brantford. Ontario 


70 THE CANADIAN NURSE 


MAIMONIDES HOSPITAL 
AND HOME FOR THE AGED 


AN OPPORTUNITy.... 
A CHALLENGE.... 
A NEW EXPERIENCE.... 


SUPERVISORS, STAFF NURSES, NURSING 
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC 
NURSE: 


We invite you to join the nursing staff of New Mai. 
monides. 


LIBERAL VACATION HEALTH AND 
PENSION PLANS _ SALARIES COM- 
MENSURA TE WITH RECOGNIZED SCALES 


Apply to: 


DIRECTOR OF NURSING 


5795 Caldwell Avenue 
Montreal 29, Quebec 


THE ST. CATHA RINES 
GENERAL HOSPITAL 


A modern 500-bed hospital located in the heart 
of the beautiful Niagara Peninsula, within 
easy travel distance from Buffalo, Hamilton 
and Toronto, invites applications from: Gener- 
al StaH Nurses. 


Pleasant working conditions. Excellent per- 
sonnel policies. 


Apply: 


The Director of Nursing Service 
THE ST. CATHARINES 
GENERAL HOSPITAL 
St. Catharines r Ontario 


FEBRUARY 196: 



DIRECTOR 
OF SCHOOL OF NURSING 


Applications are invited for the above position in a 
School of Nursing intending to revise programme in 
Fall of 1967 to a two year programme with a third 
year of experience in hospital nursing service. The 
School of Nursing is a new self-contained educational 
building, opened in 1964, with enrollment of ap- 
prox imately 140 students. 


Trent University is situated in Peterborough. 


Minimum requirement - Bachelor's Degree. Salary 
will be commensurate with qualifications and ex- 
perience. 


For further details apply to: 


Chairman of Nursing Education Committee, 


PETERBOROUGH CIVIC HOSPITAL 


Peterborough r Ontario 


KOOTENAY LAKE GENERAL HOSPITAL 


invites applications for the position of 


DIRECTOR OF NURSING 


The positian involves administration of the patient care services of 
a leo-bed modern, accredited general care hospital with medical, 
surgical, obstefrics and paediatric services. Nursing service staff 
comprises 38 graduafe nurses, 20 procfical nurses and orderlies and 
5 p.n. trainees. 
The Direcfor of Nursing would be directly responsible to fhe 
Administrafor. 
Graduation from an approved School of Nursing essential with 
experience or preparation in patient care administration desirable. 
location of the hospital is Nelson in the Kootenay lake Regian 
of Southeasfern British Columbia, centre of Notre Dome University, 
Kootenay School of Art and B.C. Vocational Training School. It is 
an area of stable economy, temperate climafe with varied edu- 
cafional, culfural, commercial, industriol. administrafive and resort 
activity. 


Please direct enquiries or applications stating 
experience, training and references to: 


Administrator, 


KOOTENAY LAKE GENERAL HOSPITAL 


3 View Street,Nelson, B. C. 


EBRUARY 1967 


MORRISTOWN MEMORIAL HOSPITAL 
MORRISTOWN, NEW JERSEY 



 


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Morristown Memorial is a modern, full-service, 355-bed regional 
hospital center with excellent opportunities for specialization and 
advancement in all types of positions within the general and spe- 
cialty fields. All services are accredited. Our planned orientation 
and continuing in-service training programs are managed by a full- 
time director and supervised by physicians, nurses, and specialists 
in related fields. Three nearby universities offer opportunity for 
advanced study. 
Here at Morristown Memorial you can further your professional 
development while enjoying the advantages of life in a friendly 
suburban community only 30 miles away from the heart of New 
York City. Attractive, low.cost apartments are available within our 
own buildings located but a few steps from the Hospital's entrance. 


Minimum starting salaries are: 
$120.00 weekly (day) . .......... $520.00 monthly 
$136.15 weekly (3-11 or 11-7) .... $590.00 monthly 
In addition, we provide a liberal program of fringe benefits. 
You advance to supervisory positions on merit; promotions 
are made from within. 
New Jersey has no state income tax. 
For full information concerning nursing opportunities, write to: 
Miss Ruth C. Anderson, R. N., Asst. Administrator 
Morristown Memorial Hospital, Morristown, New Jersey 


THE CANADIAN NURSE 71 



WOODSTOCK GENERAL HOSPITAL 


Requires 


GENERAL STAFF NURSES 


ALL DEPARTMENTS 


and 


O.R. TECHNICIANS 


Apply. 
Director of Nursing 
WOODSTOCK 
GENERAL HOSPITAL 


Woodstock, Ontario 


McKELLAR GENERAL HOSPITAL 


requires 


Registered Nurses for general Staff. The 
hospital is friendly and progressive. 
It is now in the beginning stages of a 
$3,500,000 program of expansion and 
renovation. 


- Openings in all services. 
- Proximity fo lakehead 
ensures opportunity for 
education. 


University 
furthering 


For full particulars write to: 


Acting Director 
of Nursing Service 


McKELLAR GENERAL HOSPITAL, 
Fort William, Ontario. 


ST. JOSEPH'S HOSPITAL 
SCHOOL OF NURSING 
Hamilton, Ontario 


r
uires 


CLINICAL INSTRUCTORS in all Nursing 
areas. Well-equipped, modern School of 
Nursing. Student enrolment OYer 300. 
Modern, progressiye, SOO-bed Hospital. 
Salary commensurate with preparation 
and experience. 


For further details, apply: 


DIRECTOR OF NURSING 


72 THE CANADIAN NURSE 


PORT COLBORNE 
GENERAL HOSPITAL 


PORT COlBORNE, ONTARIO 


ST AFF NURSES 


required 


For 166-bed hospital within easy driving 
disfonce of American and Canadian me- 
tropolitan centres. Consideration given for 
previous experience obtained in Canada. 
Completely furnished apartment-style resi- 
dence, including balcony ond swimming 
pool facing lake, adjacent fo hospital. 


Apply: 
Director of Nursing 
GENERAL HOSPITAL 
Port Colborne,Ontario 


REGISTERED NURSES 


For new IOO-bed General Hospital in 
resort town of 14,000 people, beautifully 
located on shores of lake of fhe Woods. 
Three hours' fro vel fime from Winnipeg 
with good transportation available. Wide 
variety of summer and winter sports- 
swimming, boating, fishing, golfing, skat- 
ing, curling, tobogganing. skiing and ice 
fishing. 
Salary: $372 for nurses registered in 
Ontario with allowance for experience. 
Residence available. Good personnel poli- 
cies. 


Apply to: 
DIRECTOR OF NURSING 
KENORA GENERAL HOSPITAL 
Kenora, Ontario 


OTTAWA CIV1C HOSPITAL 


OTTAWA, ONTARIO 


This modern 1087.bed teaching hospital 


requires: 


REGISTERED NURSES 
FOR All SERVICES INCLUDING 
OPERATING ROOM AND PSYCHIATRY 


Excellent salaries, personnel policies and 
Fringe benefits are availoble. 


Apply in writing to: 


B. JEAN MILLIGAN, Reg. N., M.A. 
Assistant Director 


ST. JOSEPH'S HOSPITAL 


lONDON. ONTARIO 


Teaching Hospital, 600 beds. new facilities 


requires : 


TEACHERS 
REGISTERED NURSES 
REGISTERED NURSING ASSISTANTS 


For further information apply : 


The Director of Nursing 
ST. JOSEPH'S HOSPITAL 
London, Ontario 


DIRECTOR OF NURSING 
EDUCATION 


Master's degree preferred; to conduct 
basic nursing program and affilliafe pro- 
gram 


Apply to: 
Director of Nursing, 
CHILDREN'S HOSPITAL 
OF WINNIPEG, 
Winnipeg, Manitoba. 


ST. THOMAS-ELGIN 
GENERAL HOSPITAL 


Requires 
GENERAL STAFF NURSES 
REGISTERED NURSING 
ASSISTANTS 
O. R. TECHNICIANS 


Modern 395 bed, fully accredited General 
Hospital opened in 1954, with School of 
Nursing. Excellent personnel policies. 
O. H. A. Pension Plan. Pleasanf progres- 
sive industrial city of 22.500. 


Apply: 
Director of Nursing, 
ST. THOMAS-ELGIN GENERAL 
HOSPIT AL 
St. Thomas, Ontario. 


FEBRUARY 1967 



OPERATING ROOM 
SUPERVISOR 


With Postgraduate Course in 
Operating Room technique 
and management 


Required for a 375-bed fully 
accredited General Hospital with 
projected reconstruction program. 
Salary based on qualifications 
and experience. 


Fringe benefits include hospital 
and medical coverage, generous 
sick leave, three weeks' vacation 
and contributory pension plan. 


For further information write: 
Director of Nursing Service 
METROPOLITAN 
GENERAL HOSPITAL 
Windsor, Ontario 


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Medical-Surgical 


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. . Good starting salary 
. . In-service education 
. . 12 paid sick days per year 
. . Tuition refund program 
. . Free life and 
disability insurance 


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Box 1434, 
125 West 41 St. 
New York, N.Y. 10036 


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An Equal Opportunity 
Employer MfF 


EBRUARY 1967 


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THE WINNIPEG GENERAL HOSPITAL 


i. Recruiting General Duty Nurse. for all Service. 


SEND APPLICATIONS DIRECTLY TO 


THE PERSONNEL DIRECTOR, 
WINNIPEG GENERAL HOSPITAL 
WINNIPEG 3, MANITOBA 


DIRECTOR, SCHOOL OF NURSINC 


Applications are invited 
for the 




 


POSITION OF DIRECTOR. 
SCHOOL OF NURSING 


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The Director will have complete charge of two-plus-one 
diploma program with 360 students, adequate faculty, 
new ultra-modern facility associated with 1000-bed 
teaching hospital. Master's degree preferred. Considera- 
tion will be given to candidate with Bachelor of Science 
in Nursing Education degree and good leadership poten- 
tial. Appointment will be made by July 1, 1967. 


For further information. write to: 
Chairman r Nursing Advisory Committee 
c/o Nursing Office, 
VICTORIA HOSPITAL 
London, Ontario. 


THE CANADIAN NURSE 73 



REGISTERED NURSES 


Staff posifions available in acute and 
convalescent unit of large General Hospital 
locafed in San Francisco Bay Area. Sfarfing 
salary $550 fo $605 plus differenfial. Ex- 
cellenf benefits. 


Apply: 
SEQUOIA HOSPITAL 
Whipple and Alameda 
Redwood City, California 


222 BED GENERAL HOSPITAL 


requires 


STAFF NURSES 
REGISTERED NURSING ASSISTANTS 


Cornwall is noted for its summer and 
winter sport areas, and is an hour and a 
half from both Montreal and Ollawa. 
Progressive personnel policies include 4 
weeks vacatian. Experience and posf-basic 
certificates are recognized. 


Apply to: 
Ass't. Director of Nursing 
(service) 
CORNWAll GENERAL HOSPITAL 
Cornwall, Ontario 


EVENING OR NIGHT 
SUPERVISOR 


For 70-bed active hospital locafed 70 
miles East of Saskafoon. Salary com- 
mensurafe wifh experience and qualifica- 
fions. Excellent personnel policies. 


Apply: 
Director of Nursing Service 
ST. ELIZABETH'S HOSPITAL 
Humboldt, Saskatchewan 


74 THE CANADIAN NURSE 


RfGlSTERED NURSES 


required for 
B2-bed hospital. Situated in the Niagara 
Peninsula. Transportation auisfance. 
for salary rates and personnel policies, 


apply to: 
Director of Nursing 
HALDIMAND WAR MEMORIAL 
HOSPITAL 


Dunnville, Ontario 


DIRfCTOR OF NURSING 


Applications are invifed for the above 
position in a modern, 56-bed, fully ac- 
credited hospital wifh expansion plans 
under active sfudy. Nursing administrative 
education and experience desirable. 
Salary commensurafe with qualificafions. 


Apply: 
Mrs. M. Fearn, Executive Director 
THE BARRIE MEMORIAL 
HOSPITAL 
Ormstown" Quebec 


PETERBOROUGH CIVIC HOSPITAL 


School of Nursing requires 


INSTRUCTRESS (Nursing Arta) 
INSTRUCTRESS (Medical.Surgical Area) 


New self-contained educafion building for 
school of nursing now open. 
T renf Universify is situafed in Peferborough 


For further information write to: 


Director of Nursing 
PETERBOROUGH CIVIC 
HOSPITAL 
Peterborough. Ontario 


SCHOOL OF NURSING 
WOODSTOCK GENERAL HOSPITAL 


Requires the following Faculty 
a) Psychiafric Teacher (One). 
b) Medical and Surgical Teachers (Two). 
Minimum requirement - B. Sc. N. 
The above additional staff is required 
for New Program. 


Apply to: 
Director of Nursing Education 
WOODSTOCK GENERAL 
HOSPITAL 
Woodstock, Ontario 


SOUTH PEEL HOSPITAL 


COOKSVlllE, ONTARIO 


A new 45Q-bed General Hospital, located 
12 miles from fhe Cify of Toronto. has 
openings fOr: 


(1) GENERAL STAfF NURSES in all de- 


partments; 


(2) Registered Nursing Assistants in all 
departments. 


For information or application, write to. 


Director of Nursing 
SOUTH PEEL HOSPITAL 
Cooksville, Ontario 


SCHOOL OF NURSING 
PUBLIC GENERAL HOSPITAL 


Chatham, Ontaria 
requires 


INSTRUCTORS 


Student Body of 130 
Modern self-contained educafion building 
Universify Preparation required with 
salary differenfial for Degree. 


For further information, 
apply to: 
Director r Nursing Education 


FEBRUARY 196 



THE HOSPITAL 


FOR 


SICK CHILDREN 



 


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YOU 


Receive the advantages of: 


1. Five-week orientation pro- 
gram for new staff. 


2. Ongoing in-service education 
for nurses. 


3. Extensive student education 
program. 


4. Research Institute. 


APPLICATION FOR GENERAL 
DUTY POSITIONS INVITED 


For information contact: 


THE DIRECTOR OF NURSING 


555 University Avenue 
Toronto, Canada 


EBRUARY 1967 


DIRECTOR 


OF 
REGIONAL SCHOOL 
OF NURSING 


"KIRKLAND LAKE" 


Applications are invited for the 
position of Director of a new 
Regional School of Nursing to be 
established in Kirkland lake with 
an annual enrollment of 30 
students encompassing five area 
hospitals. An excellent opportu- 
nity to develop a program from 
the erection of the building to 
operating the school. 


Please direct enquiries to: 
The Secretary of the Steering 
Committee: 
R. J. Cameron, Administrator, 


KIRKLAND AND DISTRICT 
HOSPITAL 


Kirkland Lake, Ontario. 


DIRECTOR 
OF NURSING SERVICE 


The Belleville General Hospital 
requires a Director of Nursing 
Service to be responsible for the 
administration of all nursing ser- 
vice activities. 


The hospital presently has a ca- 
pacity of 300 beds and will in- 
crease to a total of 450 beds in 
about one year, upon completion 
of a construction programme. 
The design incorporates a central 
Supply Process Dispatch system. 
Applicants should have a degree 
in nursing service administration 
as well as considerable expe- 
rience in a similar position. 


Applications and enquiries 
should be addressed to: 
Acting Administrator 
BELLEVILLE GENERAL HOSPITAL 
Belleville, Ontario. 


OUR DIRECTOR 
OF NURSING 
needs you 


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We're opening a brand new 120- 
bed addition and we need your 
help. We want our patients to 
have the finest of care as well as 
the finest of facilities. If you're a 
professional nurse who's inter- 
ested in enhancing your own 
career as well as improving your 
hospital's scope of care, we 
need you. 

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PRESBYTERIAN HOSPITAL CENTER 
ALBUQUERQUE, NEW MEXICO 87106 


"Starting salary to $555 a month 
--Expanding, progressive 
500.bed hospital 
--Personal orientation program 
"liberal fringe benefits 
"Continuing educational programs 
"Airline travel paid 
-*Two universities 
--Growing metropolitan area 
"Twenty minutes from nearby 
mountain ski area 
EQUAL OPPORTUNITY EMPLOYER 


Mail coupon oreall collecI(505.243.9411, Ext. 219) 


Mrs. Susan Dicke. Director of Nurse Recruitment 
Presbyterian HospItal Cenler. Department B 
Albuquerque. New MexIco 87106 


Please mail me more information about nursing 
at Presbyterian Hospital Centar and how I may 
contribute to your patient care program. 


Name 


Address 


City 


State 


School 01 Nursing 


Year of Graduallon _Month 


THE CANADIAN NURSE 75 



GRADUATE NURSES 


Eligible for registration in fhe 
Province of Ontario. 


Various posifions available os SUPER- 
VISORS, HEAD NURSES, ond GENERAL 
DUTY NURSES. Excellent opportunities for 
odvancement in all areos of modern, 
newly expanded I,OOo-bed Generol Hos- 
pital, including O.R. ond Recovery, Inten- 
sive Core, Emergency, Cenfrol Supply, 
Medicol ond Surgicol Unifs. 


Please contact: 
Director of Nursing 
HENDERSON GENERAL 
HOSPITAL 
Hamilton, Ontario 


COLONEL BELCHER HOSPITAL 
CALGARY, ALBERTA 


EDUCATIONAL INSTRUCTOR 


Up to $6,283 per annum 
(depending on qualific"tions) 
Duties: to conduct in-service troining for 
Nurses and Ancillary Stoff. " 
Qualifications: must be 0 Regisfered 
Nurse preferobly with odvanced train- 
ing in nursing educofion ond odminis- 
frofion. 


Apply immediately to the 
Personnel Office, 
COLONEL BELCHER HOSPITAL 
Calgary, Alberta 
Quote 998. 


OPERATING ROOM NURSES 


WE NEED 


YOU 


APPLY TO: 


Director of Nursing Service 
SUDBURY GENERAL HOSPITAL 
Sudbury, Ontario. 


76 THE CANADIAN NURSE 


REGISTERED GENERAL 
DUTY NURSES 


For 75-bed ocfive hospifol located 70 
miles Eost of Soskotoon. 


Excellent personnel policies. 


Apply: 
Director of Nursing Service 
ST. ELIZABETH'S HOSPITAL 
Humboldt, Saskatchewan 


SYDENHAM DISTRICT HOSPITAL 
WALLACEBURG, ONTARIO 


Exponsion, scheduled to open April I, 
1967. Regi.t.r.d Nu.... - salary range 
$400 . $480, per month commensurote 
with experience ond quolificotions. 
Regi.t.red Nu..ing A..istants - so lory 
ronge $295 - $331 per month. Excellent 
personnel polcies. 


For further information and application 
form please write: 


Mrs. M. Brevik 
Director of Nursing 
SYDENHAM DISTRICT HOSPITAL 
Wallaceburg, Ontario. 


PORT COLBORNE 
GENERAL HOSPITAL 


PORT COLBORNE, ONTARIO 
requires 
A Supervisor for evening ond nighf rOfo, 
tion of dUfy "and A Supervisor for in- 
service educofion progromme for 166-bed 
hospital within easy driving disfonce of 
Americon ond Canadian mefropolilan 
centres, considerotion given for previous 
experience obtained in Conado. Comple. 
tely furnished apartmenf-style residence, 
including bolcony ond swimming pool 
focing loke, odjocent fo hospitol. 


Apply: 
Director of Nursing 
GENERAL HOSPITAL 
Port Colborne, Ontario. 


CAMPS HIAWATHA 
IN THE LAURENTIANS 
50 mile. from Montreal and EXPO 
FOR GIRLS FOR BOYS 
To compose its Medical Sfaff 
for July ond August 1967 
requires: 
. A RESIDENT PHYSICIAN 
. TWO (2) REGISTERED NURSES 
. TWO (2) NURSES AIDES 
Sfoff for the full summer is preferred, buf 
orrangements for one monfh may be hod. 
Excellent food ond living occommodofions; 
Wonderful othlefic ond recreotional faci- 
lifies. 


Please call or write: 
CAMPS HIAWATHA INC., 
1405 Bishop Street, 
Montreal 25, Quebec 
Tel.: 844-2556 


NEW POSITION 
IN.SERVICE CO.ORDINATOR 


required 


fO direcf, supervise ond porticipate in 0 
progrom of In-Service Educofion. Require- 
ments: Baccalaureafe degree. Experience 
in nursing service and educafion. Keen 
inferest in sfoff development. Initiofive 
ond leodership ability. 


Enquire: 


Director of Nursing 
ROYAL COLUMBIAN HOSPITAL 
New Westminster, B.C. 


ROYAL ALEXANDRA HOSPITAL 


EDMONTON, ALBERTA 


Modern ocfive treotment hospital Super- 
visors required far doys, evening ond 
night dUfy for Poediofric and Medical 
Nursing Units. General DUly for 011 servi. 
ces including Infensive Core Unit. Excel- 
lent working conditions ond currenf per- 
sonnel policies. Credit will be given for 
previous experience ond Postgroduate 
quolificofions. 


Apply: 
Personnel Office, 
ROYAL ALEXANDRA HOSPITAL 
Edmonton, Alberta 


FEBRUARY 196 



I. \It.j:.. 1\..( , 


REGISTERED & GRADUATE 
NURSES 


Are required to fill vacancies in a modern, centrally 
located Hospital. Tours of duty are 7:30 - 4:00, 3:30 - 
12:00 and 11 :30 - 8:00. 
Salary range for Registered Nurses is $382.50 to 
$447.50 per month and for Graduate Nurses is 
$352.50 to $417.50 per month. We offer a full 
range of employee benefits and excellent working 
conditions. 
Day Care facilities for pre-school children from 3 
months to 5 years in age. 


Apply in person, or by letter to : 
Personnel Manager, 
THE RIVERDALE HOSPITAL 
St. Matthews Road, 
Toronto 8, Ontario. 


SCHOOL OF NURSING 
BROCKVILLE 
GENERAL HOSPITAL 


Requires 


TEACHERS 


For the recently approved two year curriculum with 
a third year of experience in nursing service. You 
will enjoy participating in the development of a 
progressive school which emphasizes planned learn- 
ing experiences for the students. Theory is taught 
concurrent with clinical experience. 
Qualifications: Bachelor of Science in Nursing 
or Diploma in Nursing Education 
or Diploma in Public Health Nursing 
Excellent salaries and personnel policies. 
You would enjoy living in the attractive "City of 
the Thousand Islands" two and one half hours from 
Expo 67. 


For further information contact: 
The Director, School of Nursing 
BROCKVILLE GENERAL HOSPITAL 
Brockville, Ontario 


BRUARY 1967 


THE MONTREAL GENERAL HOSPITAL 


offers a 
6 month Advanced Course in 
Operating Room Technique and 
Management to 
REGISTERED NURSES 


with a year's Graduate experience 
in an Operating Room. 
Classes commence in September and 
March for selected classes of 
8 students 


For further information apply to : 
The Director of Nursing 


THE MONTREAL GENERAL HOSPITAL 


Montreal 25, Quebec 


DIRECTOR OF SCHOOL 
OF NURSING 


REQUIRED FOR 
DISTRICT SCHOOL OF NURSING 


Minimum Requirement - B. Sc. N.. with five years 
experience. two of these in Nursing Education. 


Apply to: 


Mr. Harold Swanson, Chairman, 


BOARD OF NURSING EDUCATION 


220 Clarke Street 


WOODSTOCK, ONTARIO 


THE CANADIAN NURSE 77 



$700 monthly. Write: Personnel Director, Mercy Hos- 
p ital, Bakersfield, California. 15-5-58A 
REGISTERED NURSES: Excellent opportunity for ad- 
vancement in atmosphere of med ico I excellence. Pro- 
gressive patient core including Intensive Core and 
Cardiac Core Units. Finely equipped growing 200- 
bed suburban community hospital just on Chicago.. 
beautiful North Shore. Completely air conditioned 
furnished apartments, paid vacation, ofter six months, 
stoff development program, and liberal fringe bene- 
fits. Starting salary from $466. Differential of $30 
for nights or evenings. Contact: Donald L Thomp- 
son. R. N., Director of Nursing, Highland Pork Hos- 
pital, Highland Pork, Illinois 60035. 15-14-3 A 


UNITED STATES 


REGISTERED NURSES - Just over the Golden Gate 
from Son Francisco in uMorvelous Morin". Modern ex- 
panding 250 bed hospital. Opportunities in medical, 
surgical obstetrical, ICU, OR, Cardiovascular, Psychia- 
tric oreas. Dynamic inservice program. Salary. based 
on education and experience starting from $600 to 
$675. PM and night shift differentials of 10 % and 
7 %. plus liberal employee benefits. Opportunities for 
graduate study in nearby colleges and universities. 
St;mulating, progressive hospital atmosphere plus ex- 
citing off-duty attractions of nearby Son Francisco. 
the Redwoods. ocean swimming and mountain skiing. 
Contact: Personnel Director, Morin General Hospital. 
Box 30 San Rafael, Cal ifornia. 15-5-69 A 


Registered Nurses and Certified Nursing Alsistants. 
Openinq in several areas, all shifts. Every other week- 
end off, in small community hospital 2 miles from 
Boston. Rooms available. Hospital paid life insurance 
and other liberal fringe benefits. RN salary $100 per 
week, plus differential of $20 for 3-11 p.m. and 
11.7 a.m. shifts. C.N. Ass'ts. $76 weekly plus $10 for 
3-11 p.m. and 11-7 a.m. shifts. Write: Miss Byrne, 
Director of Nurses. Chelsea Memmorial Hospital, 
Chelsea, Massachusetts 02150. 15-22.1 C 


REGISTERED NURSES - CALIFORNIA Progressive hos- 
pital in San Joaquin Volley has openings for R.N:s. 
Located between Son Francisco end Los Angeles near 
mountain. ocean and desert resorts. Paid vocation. 
paid sick leave. paid Blue Cross. disability insurance, 
voluntary retirement plan. Salary range from $500 to 



Bli
 


SCHOOL FOR GRADUATE NURSES 
McGill UNIVERSITY 




 

 


PROGRAMS FOR GRADUATE NURSES 
DEGREE OF BACHELOR OF NURSING 


Two yeors from McGill Senior MOfriculofion or three years from McGill Junior 
MOfriculotion or the equivolents. In First Yeor fhe student elects one clinical 
setting in which to study nursing, selecting from 
. Mafernol ond Child Health Nursing 
. Medicol-Surgicol Nursing 
. Mental Heolfh and Psychiotric Nursing 
. Public Heolfh Nursing 
In Final Yeor fhe sfudenf studies in nursing educolion, or nursing service 
supervision, selecting from 


· Teoching of Nursing 
. Supervision of Nursing Service in Hospifals 
. Supervision of Public Health Nursing Service 


DEGREE OF MASTER OF SCIENCE (APPLIED) 


A progrom of two ocodemic yeors for nurses wifh 0 boccoloureofe degree. 
Students elect to mojor in: 
. Development and Administrotion of Educotionol Progroms in Nursing 
. Nursing Service Adminisfrofion in Hospitols ond Public Heolth Agencies 


PROGRAM IN BASIC NURSING 
leading to the degree Bachelor of Science in Nursing 


A five.yeor progrom for students with McGill Junior Mafriculotion Or its equivalent. 
This progrom combines ocodemic ond professional courses with supervised nursing 
experience in fhe McGill teoching hospifols ond selected heolth ogencies. This brood 
bockground of educafion, followed by graduofe professional experience, prepores 
nurses for odvanced levels of service in hospifals ond communify. 


for further particulars write to: 


DIRECTOR, McGILL SCHOOL FOR GRADUATE NURSES 
3506 UNIVERSITY STREET, MONTREAL 2, QUE. 


78 THE CANADIAN NURSE 


, '":1''' 
 


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DALHOUSIE 
UNIVERSITY 


Degr.. Course in Bosic Nursing - (B.N.) 
4 years 
A progrom extending Over four colendor 
yeors leading to the Bachelor of Nursing 
degree is offered to candidates wifh a 
Nova Scofia Grade XII sfonding (or equiv- 
alenf) and prepares the student for nursing 
proctice in hospitals ond the community. 
The curriculum includes sfudies in the 
humonities, nursing and the sciences. 


Degree Course for Registered Nurses - 
(B.N.) - 3 years 


A progrom extending over three ocademic 
yeors is offered to Registered Nurses who 
wish to obtain 0 Bachelor of Nursing 
degree. The course includes studies in 
the humonities, sciences ond 0 nursing 
specialty. 
Diploma Courses for Registered Nurses - 
1 yea. 


(1) Nursing Service Administration 
(2) Public Health Nursing 
(3) Teaching in Schools of Nursing 
For further information apply to: 
Directo., School of Nursing 


DALHOUSIE UNIVERSITY 


Halifax, N.S. 


DALHOUSIE UNIVERSITY 
offers 
NEW DIPLOMA PROGRAM 


in 


OUTPOST NURSING 


A program exfending over two colendar 
yeors hos been developed to prepare 
graduote nurses for service in remofe 
areos of Northern Canada. Mojor oreas 
wifhin the course of study will include: 
Public heolth nursing 
Complete midwifery 
Bosic clinicol medicine 
Insfruction will be highly individualized. 
1st yeor - To be spent ot the Universify. 
2nd yeor - To consist of on internship 
directed by the Universify in 
selected northern ogencies. 
Condidofes should hove completed of 
leost one yeor of professional nursing. 
Upon completion of the progrom sfudents 
will receive 0 Diploma in Public Heolth 
Nursing ond 0 Diplomo in ÛlJfpost 
Nursing. 


For further information write to: 
Director, 
SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY 
Halifax, Nova Scotia 


FEBRUARY 191 



UNITED STATES 


iTAFF NURSES - Here is the opportunity to further 
ievelop your professional skills and knowledge in 
.ur I,OOO-bed medical center. We have liberal perso.nnel 
>elicies with premiums for evening and night tours. 
)ur nurses' residence, locoted in the midst of 33 
ultural and educational institutions, offers low-cost 
10using adjacent to the Hospitals. Write for our booklet 
>n nursing opportunities. Feel free to tell UI whot type 
)osition you are seeking. Write: Director of Nursing, 
loom 600, University Hospitals of Cleveland, University 
:ircle, Cleveland, Ohio 44-06 15-36-1 G 


:egiltered Nur.. (Scenic Oregon vocation ploy- 
,round, skiing, swimming, boating & cultural 
.vents) for 295.bed teaching unit on campus of 
Iniversity of Oregon medical school. Salary starts 
.t $575. Pay differential for nights and evenings. 


Liberal policy for advancement, vocations, sick 
leave, holidays. Apply: Multnomah Hospital, Port. 
land, Oregon. 97201. 1:1-38-1 


Staff Nurs..: live with your family in on atTractive 
2 bedroom furnished home for $55 per month, 
including utilities, and work in a suburban Cleve- 
land hospital. Starling salary range $420 - $445 
with 6 and 12 month increments. Excellent transpor- 
tation to hospital door. Outstanding schools and 
cultural opportunities. Apply: Director of Nursing 
Service, Sunny Acres Hospital, 4310 Richmond Road, 
Cleveland, Ohio 44t22. 15-36-IE 


GRADUATE NURSES - Wouldn't you like to work 
at a modern 532.bed acute General Teaching Hos- 
pital where you would have: (0) unlimited oppor- 
tunities for professional growth and advancement, 
(b) tuition paid for advanced study, (c) starting 
salary of $429 per month (to those with pending 
registration as well), d) progressive personnel poli- 


ROYAL VICTORIA HOSPITAL 
SCHOOL OF NURSING 


MONTREAL, QUEBEC 


POSTGRADUATE COURSES 


1. 


(a) . Six month clinical course in Obstetrical Nursing. 
Classes - September and March. 


(b) 


Two month clinical course in Gynecological Nursing. 
Classes following the six month course in Obstetrical 
Nursing. 
Eight week course in Care of the Premature Infant. 


(c) 


2. Six month course in Operating Room Technique. 
Classes - September and March. 


3. 


Six month course in Theory and Practice in Psychiatric 
Nursing. 
Classes - September and March. 


For information and details of the courses, apply to: 


DIRECTOR OF NURSING 


ROYAL VICTORIA HOSPITAL 


Montreal, P.Q. 



BRUARY 1%7 


des, (e) a choice of areas? For further information, 
write or call colle-ct: Miss Louise Harrison, Dire-ctor 
of Nursing Service, Mount Sinai Hospitat University 
Circle, Cleveland, Ohio 44106. Phone SWeetbriar 
5-6000. 15-36.ID 


STAFF NURSES: University of Washington. 320-bed 
modern, expanding Teaching and Research Hospital 
located on campus offers you an opportunity to 
join the staff in one of the following specialties, 
Clinical Research, Premature Center Open Heart 
Surgery, Physical Medicine, Orthopedicts, Neurosur- 
gery, Adult and Child Psychiatry in addition to 
the General Services. Salary: $501 to $576. Unique 
benefit program includes free University courses after 
six months. For information on opportunities, write 
to: Mrs. Ruth Fine. Director of Nursing Services, 
University Hospital, 1959 N.E. Pacific Avenue, 
Seattle, Washington 98105. 15-48-2D 


UNIVERSITY OF 
BRITISH COLUMBIA 


School of Nursing 


DEGREE COURSE IN BASIC 
NURSING 
DEGREE COURSE FOR 
GRADUATE NURSES 


Both of these courses lead to the 
II.S.N. degree. Graduates are pre- 
pared for public health as well as 
hospital nursing positions. 


DIPLOMA COURSES FOR 
GRADUATE NURSES 


I. Public Health Nursing. 
2. Administration of Hospital 
Nursing Units. 
3. Psychiatric Nursing. 


For information write to: 
The Director 
SCHOOL OF NURSING 
UNIVERSITY OF B.C. 
Vancouver 8, B.C. 


OPERATING ROOM NURSE 


FOR 


DEEP RIVER HOSPITAL 


Must hove successfully completed 0 post- 
graduafe course in operating room tech- 
niques or have had two or three yeors 
experience. Fringe benefifs include super. 
onnuation, holidays, group insurance, hOl- 
pito! ond medical plans. 


State all particulars in first letter to: 


FILE 11 E 
ATOMIC ENERGY 0 CANADA 
LIMITED 
Chalk River, Ontario. 


THE CANADIAN NURSE 79 



MY VERY OWN 
STETHOSCOPE? 


. 


'- 


- but of course! 



 


ASSISTOSCOPE* was 
designed with the 
nurse in mind. 


ASSISTOSCOPE* gives 
you the acoustical 
perfection of the 
most expensive 
stethoscopes. 


ASSISTOSCOPE::: is available with black or 
hospital-white tubing and ear pieces with the slim-fit 
sonic head which slips easily under blood pressure cuffs 
or clothing. 


tCheck with your Director 
of Nurlinl or P.A. today 
on how you can buy 
ASSISTOSCOPE at 
speciallroup prices. 


Order fromt 
v../ 





N
U



I


 
M MONTREAL 21 QUE.EC 
.TRADE MARK 


VICTORIA GENERAL HOSPITAL 


HALIFAX, NOVA SCOTIA 


Invites applications from Registered Nurses 
for all services including operating room, 
recovery room, intensive care and emergency 
in completely new wing. 


Salary range for General Staff positions 
$360.00 - $420.00 per month 
and other liberal benefits. 


Direct enquiries to: 


Director of Nursing, 


VICTORIA GENERAL HOSPITAL 


3383 


Halifax, Nova Scotia 


80 THE CANADIAN NURSE 


Index 
to 
advertisers 
February 1967 


Abbott Laboratories Ltd. 
Ames Company of Canada Ltd. 
Bland Uniforms Limited . 
Boehringer Ingelheim Products .. 
British Drug Houses (Canada) Ltd. 
The Clinic Shoemakers .. 
Canadian University Service Overseas 
Depårtment of National Defense, Ottawa ... 
Four Seasons Travel .. 
Charles E. Frosst & Co. 
W. J. Gage Co. Ltd. ...... 
Lakeside Laboratories (Canada) Ltd. 
Lewis-Howe Company (Turns) 
J. B. Lippincott Co. of Canada Ltd. 
Mead Johnson of Canada Ltd. 
C. V. Mosby Co. 
J. T. Posey Company 
Reeves Company .... 
W. B. Saunders Company 
Sterilon of Canada 
Uniforms Registered 
United Surgical Corporation 
White Sister Uniforms Inc. 
Winthrop Laboratories .... 


Advertising 
Manager 
Ruth H. Baumel, 
The Canadian Nurse 
50 The Driveway, 
Ottawa 4, Ontario 
Advertising Representatives 
Richard P. Wilson, 
219 East Lancaster Avenue, 
Ardmore, Penna. 19003 
Vanco Publications, 
170 The Donway West, 
Suite 408, Don Mills, Ont. 
Member of Canadian 
Circulation Audit Board Inc. 


14, 15 
17 
9 
20 
52 
2 
26 
22 
19 
16 
21 
5 
57 
24 
54 
11 
6 
12 
1 
53 
Cover III 
55 


Cover II 
Cover IV 


mE 


FEBRUARY 1967 



March 1967 


U
IVE
SITY OF OTTAWA. 
SChOOL OF NURSING 
OT':'lÎi\A. aNT. 


12-67-Q-L-I04-D 


The 
Canadian 
Nurse 



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G .- 

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health care in the north 
drug addiction 
standardization of hospital 
equipment 
total care - for animals 



Three outstanding professional fashions from WH ITE SISTER 


1 
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These three exquisite White Sister luxury professionals Seen here (and many others) are available at fine uniform shops and department stores everywhere 
For the store nearest you, write: 


WH ITE SISTER 


70 MOUNT ROYAL WEST, MONTREAL, QUE. 



. . . in pediatric 
nursing 


. . . in chemistry 


. . . in surgical 
nursing 


The revised and updated new edition of this widely- 
adopted text is a well-rounded, authoritative presentation 
of the fundamentals of inorganic, organic and physiological 
chemistry for nurses. Practical applications of chemistry to 
nursing are made throughout this new edition. New chap- 
ters discuss: miIIiequivalents; nucleoproteins and nucleic 
acids; electrolyte balance; water balance; acid-base bal- 
ance; biochemistry of genetics. The new interpretation of 
the mechanism of chemical reaction is explained and the 
distribution of electrons in the shells and subshells of the 
outer structures of atoms is discussed in detail. 
By JOSEPH H. ROE, Ph.D. Publication date: March, 1967. 10th edition, 
approx. 412 pages. 6 3 .4" x 9 3 .4", 55 illustrations, 3 in color. About 
$7.50. 


A New Book! 
PEDIATRIC NURSING 
Effectively integrating psychological aspects of child care 
with a clear, comprehensive description of pediatric nurs- 
ing, this authoritative new text incorporates the best 
features of the patient-centered and disease-oriented ap- 
proaches to pediatric nursing. Full chapters discuss visual 
testing, common psychometric tests, nonnal nutrition and 
mental retardation. Specialized areas of clinical pediatrics 
and infonnation on growth and development are discussed 
in great depth. The latest thinking is presented on: care 
of the child with congenital heart disease; common inborn 
errors of metabolism; prenatal influences on the baby in 
utero. 
By HELEN C. LATHAM, R.N., B.S., M.L., M.S.; and ROBERT V. 
HECKEL, B.S.. M.S.. Ph.D. With the collaboration of ROBERT P. 
THOMAS. M.D.. and MARGARET MOORE, B.S., R.N. Publication date: 
May. 1967. Approx. 640 P a g es, 7" x 10" 139 illustrations About 
$8.10. ,. 


New 5th Edition! 
A LABORATORY GUIDE IN CHEMISTRY 


The new edition of this completely up-to-date manual pre- 
sents 65 exercises on inorganic, organic and physiological 
chemistry for nurses, and includes new exercises on ioniza- 
tion and thin-layer chromotography. Though designed for 
use with the new 10th edition of Roe, PRINCIPLES OF 
CHEMISTRY, it easily adapts to use with any required text. 


By JOSEPH H. ROE. Ph.D. Publication date: March, 1967. 5th edition, 
approx. 240 pages, 5%" x 8%". 12 illustrations, 2 color plates. 
figures A to L. About $4.05. 


New 4th Edition! 
CARE OF THE PATIENT IN SURGERY 
Including Techniques 
Presenting the newest concepts and approaches in care of 
the patient in the operating room, the thoroughly revised, 
superbly illustrated new edition of this popular text em- 
phasizes fundamental principles in providing authoritative 
guidance in all aspects of the nurse's duties in surgery. Two 
entirely new chapters, "Surgery on the Ear" and "Ophthal- 
mic Surgery," have been added. Basic requirements of an 
operating room nursing service are definitively explained, 
including a new approach to surgical suite design. The 
most recent advances in chest, heart and gynecologic sur- 
gery are discussed in detail 
By EDYTHE LOUISE ALEXANDER, B.S., M.A., R.N.: WANDA BURLEY, 
B.S., M.A., R.N.; DOROTHY ELLISON, B.S., M.A., R.N.; and ROSALIND 
VALLERI, B.S., M.A., R.N. Publication date: March, 1967. 4th edition, 
approx. 810 pages, 7" x 10", 555 illustrations, 5 in color. About $15.70. 


THE C. V. MOSBY COMPANY, L TO. 
 
86 Northline Road. Toronto 16, Ontario 
 


lARCH 1967 


Publishers 


THE CANADIAN NURSE 


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2 THE CANADIAN NURSE 


MARCH 196; 



The 
Canadian 
Nurse 


A monthly journal for the nurses of Canada published 
in English and French editions by the Canadian Nurses' Association 


Volume 63, Number 3 


26 Katherine E. MacLaggan - A Tribute 
29 Medical Care of Eskimo Children 
32 Nursing in the North 
34 Outpost Nursing 
36 Drug Dependency Research - 
Expensive Luxury or Necessary Commodity? 
39 Use of Narcotics in Addict Therapy 
42 Care of Patients Addicted to Non-narcotic Drugs 
45 Deserter of People? 
47 Standardization 
49 Hospital and Health Care - What Price? 


March 1967 


N. Steinmetz 


Ruth E. May 


Ingeborg Paulus 
Robert Halliday 
Mary L. Epp 
Jean Wilkinson 
George T. Maloney 
S. J. Maubach 


The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association 


4 Letters 23 Dates 
7 News 51 Research Abstracts 
18 Names 53 Books 
21 In a Capsule 58 Films 
22 New Products 88 Official Directory 


Cover photo courtesy l'Iiational Health and Welfare, Ottawa. 


Executive Director: Heten K. Mussallem . 
Editor: Vlrgtnla A. Llndabury . Assistant 
Editor: Gtennls N. ZUm . Editorial Assistant: 
Carla D. Penn . Circulation Manager: pter. 
reUe HOUe . Ad\erlising Manager: Ruth H. 
Bdumet . Subscrtptton Rates: Canada: One 
Year. $4.50; two years, S8.00. Foreign: One 
Year, $5.00; two years, S9.00. Single copies: 
50 cents each. Make cheques or money orders 
pa}able to The Canadian Nurse . Change of 
Address: Fûur weeks'. notice and the old 
address as well as the new are necessary. Not 
responsible for journals lost in mail due to 
errors in address. 
Ci:) Canadian Nurses' Association. t966 


o\RCH 1967 


Manuscrtpt Informatton: "The Canadian 
Nurse" welcomes unsolicited arlicles. All 
manuscripts shoutd be typed. double-spaced. 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editoriat changes. 
Photographs (glossy prints) and graphs and 



gr;cl
O
:
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iN
 


i
 
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ict
s
'J!

 Pe"Æ

: 
is not committed to publish all articles sent, 
nor to indicate deli",te dates of publication. 
Authorized as Second-Class Mail by the Post 
Office Deparlment. Ottawa, and for _ payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4. Ontario. 


We mourn the death of our 
President, Katherine E. MacLaggan. 
The poignancy of our grief is 
intensified by knowing that one of the 
country's greatest leaders in nursing 
has been taken from us prematurely. 
Our consolation lies in the legacy 
of inspiration and example that she 
bequeathed to us. 
Our greatest tribute to the late 
president will be found not in words, 
but in action - action that 
continues her work and builds on 
and elaborates her beliefs. 
Dr. MacLaggan's objective was 
to make the Canadian Nurses' 
Association the strongest force for 
nursing leadership in the country. 
She was convinced that CNA haa to 
speak out on issues affecting nurses 
and nursing, and had to be the 
body that generates action. She also 
was convinced that the Association 
had underestimated its own power 
for exerting influence. "We are 
80,000 members banded together," 
she often said, "and we have never 
tapped our resources." 
"Think big" was a frequent 
admonishment from Dr. MacLaggan 
when there was temptation to place 
expediency first. She believed that if 
Association objectives were to be 
achieved, we could no longer "think 
small" in terms of money, resources, 
or other decisions that would affect 
future generations of nurses. 


Dr. MacLaggan always "thought 
big." Those who continue her work 
can do no less. - Editor. 


THE CANADIAN NURSE 3 



letters 


{ 


Letters to the editor are welcome. 
Only signed letters will be considered for publication 
Name will be withheld at the writer's request. 


Revised income tax act 
Dear Editor: 
I was delighted to read "Wanted - a 
Revised Income Tax Act" (Editorial, Jan- 
uary, 1967). Hoorah for you. We have 
been quiet far too long. 
Many of us mothers wonder whether it 
is worthwhile to continue to put our skills 
and knowledge to work. You have revived 
the spark in us. Guide us in speaking "loud- 
ly enough and in unison." 
I would like to congratulate the staff 
on the excellent issues that have been 
published. - (Mrs.) J. Fedak, B.Sc.N.. 
Toronto, Ontario. 


Dear Editor: 
We have sent a copy of your editorial 
(January, 1967) with a covering letter to 
our local M.P. and a petition with 64 names. 
Maybe our action will spur on other nursing 
groups to do the same. - (Mrs.) O. Raws- 
thorne, inservice education instructor, Vic- 
toria General Hospital, Winnipeg, Man. 


Not censored 
Dear Editor: 
An R.N. South Africa stated in "Letters" 
(November 1966) that pages 17 and 18 
had been removed from her June 1966 
issue. She stated .....themail is censored 
here and I would like to know what was on 
the page that made them tear it off." 
I checked the particular issue in the 
library of the South African Nursing As- 
sociation and find that page 17 carries an 
advertisement by the Canadian Tampax 
Corporation offering free color charts of 
the standing female pelvic and reproductive 
organs. Page 18 carried the excellent "New 
Products'. section. 
It seems that somebody was interested 
in the products advertised, for it is a fal- 
lacy that mail is censored in this country. - 
Dr. Charlotte Searle, director, Division of 
Professional Development, The South Afri- 
can Nursing Association. 


Extra copiesl 
Dear Editor: 
We are in need of copies of the January, 
February, and March 1966 issues of THE 
CANADIAN NURSE for our library and school 
of nursing. If any readers have copies of 
these issues available we would appreciate 
receiving them. - R.N., Ontario. 


A \lailable copies can be sent to The 
Canadian Nurse, 50 The Dri\leway, Otta- 
wa 4, Ontario. - Editor. 
4 THE CANADIAN NURSE 


University education 
Dear Editor: 
I wish to congratulate you and your co- 
workers for the last issue of L'lnfirmière 
Canadienne, which featured articles on uni- 
versity nursing education. 
We were very pleased with its presenta- 
tion and I am personally very proud to see 
it circulated throughout Canada and 
abroad. - Sister Jacqueline Bouchard, 
Director, School of Nursing, Université de 
Moncton. 


Dear Editor: 
I read with great interest the December 
issue, particularly the articles by Glenna 
Rowsell and Margaret Steed. - Vera Osto- 
povitch, nursing service advisor, Saskat- 
chewan Registered Nurses' Association. 


Dear Editor: 
I enjoyed Glenna Rowsell's article in the 
December issue. I want to congratulate 
her on a fine job. - Myrtle Pearl Stiver, 
former executive director of the Canadian 
Nurses' Association. 


Dear Editor: 
I am very pleased to have an extra 
copy of THE CANADIAN NURSE for Decem- 
ber, which contains the feature on "Uni- 
versity School of Nursing in Canada." 
I think the article is very nicely done 
and of service not only to prospective 
students but to those of us in the schools 
who meet so infrequently. 
Please convey our appreciation to your 
staff members with whom we had a pleasant 
visit here in Montreal last summer. 
Elizabeth Logan, Director, School for 
Graduate Nurses, McGill University. 


Dear Editor: 
Thank you for the complimentary copy 
of THE CANADIAN NURSE. I think the article 
is very well done and you will be pleased 
to know that as a result we have had ap- 
plications to our school from other pro- 
vinces. - Joyce Nevitt, Director, School 
of Nursing, Memorial University of New- 
foundland. 


Dear Editor: 
Thank you for your extra issue of THE 
CANADIAN NURSE with the article on the 
universities. It was a very kind gesture 
and I do wish to compliment you on this 
article. It will be most helpful, I am sure. 
- Sr. Françoise Robert, s.g.c., director, 
University of Ottawa School of Nursinll. 
Ottawa. 


From the four corners 
Dear Editor: 
I read with interest "Nurses on tho 
Move," a letter to the editor by Mis 
Rosemarie Gascoyne (October 1966) 
Could we have permission to reprint it il 
our Philippine Journal of Nursing? It wi! 
be interesting reading for our nurses her 
in the Philippines. 
A suggestion that caught my attentio 
is the possibility that the Internation
 
Nurses Association could "produce a syster 
where a nurse would be acceptable an. 
able to work in any country." I hope th 
ICN will be able to evolve a commo 
basic curriculum for approval of the bod 
at the coming ICN conference in Canad. 
I see a new look in The Canadia 
Nurse. The cover page is pleasing to be 
hold! Of all the magazines we have in Ol 
library, your journal is the most referee, I 
to by students and graduate nurses. - J05 I 
E. Sumagaysay, executive secretary, Phi 
lippine Nurses Association. I 
Dear Editor: 
Thank you for an excellent nursing ma
 
azine which has become the best in an 
country. For years I have been passing m 
copies on to students and graduates alikf 
and they all comment that THE CAN ADlAI 
NURSF has the best articles printed. 
"Letters" (January, 1967) was most ir 
teresting to me, an obstetrical supervisol 
but I believe the finest article was in th 
November, 1966 issue. I have read Mh 
Pepper's article over and over again. I w
 
reading between the lines as I knew all c 
the girls in the army pictures and spent som 
time in Italy with No. 14 e.G. Hospiu 
during the war. Keep up the good work. - 
Marjorie (Lodge) Collister, Riverdale, I 
linois. 


Dear Editor: 
I very much enjoy my monthly copy 0 
THE CANADIAN NURSE. It is so informativ 
and up-to-date! When one is away fror 
home, in another country, news of one' 
fellow nurses is wonderful for the morale 
- Ruth A. Jort, Des Moines, Iowa. 


Dear Editor: 
I enclose a draft for my subscription t 
THE CANADIAN NURSE for two further year. 
In my opinion this is the best of th 
nursing journals - all articles on a specifi 
subject are contained in the same issu 
rather than in several. This saves the bothe 
of collecting them all together. - W.P 
S.R.N., Cumberland, England. 
MARCH 196' 



llin spite of today's apparent explosion 
in their awareness of sex, 
young people are not well informed." 


A recent study indicated that even 
among college girls enrolled in health 
education classes knowledge of menstru- 
al facts was neither thorough nor accu- 
rate. One reason, perhaps, for the lack 
of accuracy was the fact that only 8% of 
these girls obtained their information 
about menstruation from doctors, nurses 
or teachers. 
Thi
 small percentage probably 
learned about menstruation because 
they asked. Many young girls, however, never ask for 
information-because they feel menstruation is not a 
subject for discussion outside their homes. (And 
sometimes very little information is available within 
their homes.) Even the doctor is not likely to be con- 
sulted unless the girl is concerned about a possible 
abnormality. 
One solution to this problem is to make information 
on menstruation available to all young girls-whether 


" 


TAM PAX 

 


SANITARY PROTECTION WORN INTERNALLY 
MADE ONLY BY CANADIAN T.
MPAX CORPORATlON'LTD., 
BARRIE, ONT. 


ARCH 1967 



 


or not they specifically ask for it. Thus, 
girls in health and physical education 
classes, girls visiting school nurses, girls 
at summer camp, girls consulting their 
doctors-all should be provided with in- 
formation on the normal changes that 
are a part of growing up. 
To assist you in explaining menstru- 
ation to these girls we offer you (without 
charge) laminated plastic charts drawn 
by Dr. R. L. Dickinson, showing schemat- 
ic illustrations of the organs of the female reproduc- 
tive system. For the young girl we provide two free 
booklets answering her questions about menstruation. 
Send for them today. Professional samples of Tampax 
menstrual tampons will also be included. 


. 
. 


--- 


- 


..' 


1 Israel. S Leon: Obst. & Gynec. 26:920. 1965. 2 Larsen. 
Virginia L. J. Am. M. Women's A. 20.557, 1965. 


Canadian Tampax Cor,poration Limited, 
P.O. Box 627, Barrie, Ont. 
Please send free a set of Dickinson charts, copies of the two booklets, 
a postcard for easy reordering and samples of Tampax tampons. 


Name 


Address 


CN-I 


THE CANADIAN NURSE 5 



metronidazole 


trichomonacide 


oral tablets of 250 mg 
vaginal tablets of 500 mg 


Full information is available on request. 


-Ru I e n c ""OH" 


6 THE CANADIAN NURSE 


MARCH 1967 



news 


Committee on Nursing Education 
Begins Biennium 
Canada's 188 nursing schools - diploma 
and basic baccalaureate programs - gradu- 
ated a total of 7,360 nurses in 1965. This 
was an increase of on1y 99 over the previous 
year. This small increase is not sufficient to 
maintain present demands for nurses and 
could result in an increasing shortage of 
nurses with the coming of Medicare. 
These figures were presented by Mrs. Lois 
Graham-Cumming. Research Department. 
Canadian Nurses' Association, to the Stand- 
ing Committee on Nursing Education at its 
first meeting of the 1966-68 biennium in 
mid-February. 
They represent on1y one of the problems 
under consideration by the committee. 
Chainnan Kathleen Arpin reminded the 
committee, comprised of the elected repre- 
sentatives on nursing education from the 
10 provincial associations, that as a national 
organization the CNA must undertake to 
provide realistic policies and definitive state- 
ments on nursing and nursing education. 
The committee's job is to investigate thor- 
oughly and recommend appropriate policies 
to the Board for consideration and action. 
The committee is expected to examine 
certain specific areas of nursing education. 
Recommendations regarding a definitive 
statement on nursing, admission criteria in 
schools of nursing, and the need for and 
utilization of resources and facilities essential 
for the practice and learning of nursing will 
likely be made to the Board during the next 
biennium. 


Nation-wide Exams for 
Canadian Nurses? 
The first meeting of the Canadian Nurses' 
Association's ad hoc committee on National 
Examinations was held in Ottawa on January 
23-25, 1967. The committee had been asked 
to explore and assemble all data pertinent 
to the development of a Canadian system 
of registration examinations (machine-scor- 
ed), and to make recommendations to the 
CNA Board of Directors as to possible CNA 
involvement. 
The need for immediate action on Cana- 
dian nursing examinations has arisen because 
the American Nurses' Association recom- 
mended at their meeting in June, 1966, that 
the National League for Nursing discontinue 
the use of examinations in jurisdictions out- 
side the United States. The National League 
for Nursing has notified those provinces 
that are now using the examinations that 
they will not be available as of 1969. 
MARCH 1967 


CNA Auxiliary Meet 


. 


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.... 


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, 


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Two members of the Canadian Nurses' Association National Office Auxiliary, 
Miss E. Cale, President (right) and Mrs. G.p. Williams (left) examine a recent 
issue of The Canadian Nurse with Editor Virginia Lindabury. The Auxiliary, 
which was organized in 1955 to entertain international visitors and to help 
with the cataloguing and indexing of periodicals in the CNA library, held 
its annual meeting early in February at National Office. 


At the three-day meeting, the committee 
investigated measures for developing a Cana- 
dian system of examinations, and considered 
interim measures for the provinces until such 
a service could be established. 
Mrs. Mary Shields, fonnerly of the Test 
Construction Unit of the National League 
for Nursing, was guest speaker at the meet- 
ing. She spoke on the procedures and prob- 
lems in the development of licensure exam- 
inations. 


The committee has prepared recommenda- 
tions for submission to the Board of Di- 
rectors meeting in March. 


Official Opening - CNA House 
Her Excellency, Madame Georges P. 
Vanier, wife of Canada's Governor-General, 
will officially open the new home of the 
Canadian Nurses' Association on Wednes- 
day, March 15, 1967. 
The opening of CNA House will precede 
the meeting of the CNA Board of Directors 
on March 16 and 17 so that full repre- 
sentation of all association members will be 
assured. 


On this occasion the Board, on behalf of 
all CNA members, will be host to state 
officials and representatives of national asso- 
ciations and agencies who will be invited to 
attend the ceremonies. 
The first sod for the $800,000 building 
was turned on April I, 1965. The office 
building provides 20,000 square feet of office 
space. Architect J.W. Strutt designed the 
building. 


Nurses Speak at Hospital 
Administrators' Meeting 
Four nurses formed the faculty for a 
day at the Second Educational Assembly 
on Hospital Administration held by the 
American College of Hospital Administra- 
tors, District 8, in Winnipeg early in Jan- 
uary. 
Miss Margaret Steed, Consultant, Nurs- 
ing Education for the Canadian Nurses' 
Association; Miss Jean Anderson, Director 
of Nursing Service at Victoria Public Hos- 
pital, Fredericton; Sister Thérèse Caston- 
guay, Superintendent of Nursing Educa- 
ûon for Saskatchewan; and Mrs. K. Mc- 
Laughlin, Research Analyst in Nursing at 
the Victoria General Hospital, Winnipeg, 
THE CANADIAN NURSE 7 



news 


examined the question "Who will give nurs- 
ing care?" on the first day of the sessions. 
"Nursing care should be given by a 
nurse, qualified and registered for the prac- 
tice of nursing. Until nursing care is ad- 
ministered by nurses we cannot hope to 
solve our nursing service problems quali- 
tatively," Miss Steed told the audience. 
She defined the CNA's recommendations 
regarding the two categories of nurses, their 
preparation and utilization as a means for 
improving patient care. "The care func- 
tions are the ones now most often dele- 
gated to nursing assistants and nursing 
aides." She noted that nursing service will 
need to be complimented by auxiliary per- 
sonnel, but told the hospital administra- 
tors that a need for interpretation and cla- 
rification of the roles, functions, and res- 
ponsibilities of all those employed to per- 
form nursing services was essential. 
About 140 hospital administrators from 
across Canada attended the five-day meet- 
ing. The seminar sessions on "problem 
areas," at which the nurses spoke, was 
limited to 50 delegates to ensure effective 
participation in the discussion. 


Institutes on New Educational 
Program in Saskatchewan 
.'\ series of six workshops on nursing 
education are being sponsored by the Saska- 
tchewan Department of Education, Nursing 
Education Division. The workshops are for 
teaching personnel in nursing schools and 
other persons interested in the proposed 
changes in nursing education in the province. 
Three workshops are scheduled for Regina 
and three for Saskatoon. They were organiz- 
ed to help prepare nurse educators for 
changes that have revolutionized the pattern 
of nursing education within the province 
since the responsibility for nursing educa- 
tion was transferred from the Department 
of Public Health to the Department of 
Education in April, 1966. 
The changes include the est<lblishment of 
two regional schools and the closure of all 
existing hospital nursing programs. The first 
of the two regional schools is expected to 
open its doors to some 250 students this 
fall in Saskatoon. Hospital schools in Prince 
Albert, Humboldt, Yorkton, and Saskatoon 
will no longer admit students. No date has 
been set for the opening of the regional 
school for the southern region of the pro- 
vince, and hospitals there will continue to 
operate existing programs. 
Miss D. Rowles, supervisor of the nursing 
program at Ryerson Poly technical Institute 
in Toronto, was guest speaker at the fÌlst 
institute on January 17 in Saskatoon. She 
spoke on nursing programs within education- 
al institutions. Dr. H.K. Mussallem, exe- 
cutive director of the Canadian Nurses' 


8 THE CANADIAN NURSE 


Auxiliary Donates Bus Shelter 

 '\ 
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The Riverview Hospital Auxiliary in 
Windsor recently made a unique and 
practical contribution to patients and 
their visitors. At a cost of $1,650 the 
Auxiliary had a bus shelter built directly 
across from the hospital. 
According to Phyllis Purcell, public 
relations chairman of the Riverview 
Auxiliary, the need for a bus shelter to 
pratect hospital visitors from the cold 
winds that blow across the Detroit River 
has been recognized for some time. Last 


.0 ... 



 
'. 


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year, the hospit<ll board asked the Auxil- 
iary to assume the cost of this project. 
The Auxiliary hoped to have a metal 
shelter built, but the cost was prohibitive. 
Realizing that the shelter did not have 
to be glamorous to serve its purpose, the 
Auxiliary settled for a wooden building. 
The design was approved by the city and 
the shelter erected. 
Now, both visitors and st<lff at River- 
view can await the bus in comfort 
thanks to an enterprising Auxiliary. 


Association, addressed the second meeting 
on February 24 in Regina. She stressed the 
need for nurses to welcome change in our 
nursing education practices, and pointed out 
that change was long overdue. 
Other workshops will be held in Regina 
on April 17-18, when Mrs. M. Levine of 
Chicago will speak on the selection of learn- 
ing experiences, and in May, when Dr. R.N. 
Anderson will discuss the evaluation of stu- 
dent performance. In Saskatoon, Miss H. 
Keeler, director of the nursing program 
at the University of Saskatchewan, will 
speak March 22 on the reasons for shorten- 
ing nursing programs. In June, a workshop 
on teaching by principles will be directed 
by Mrs. R. M. Coombs of Hamilton, On- 
tario. 
Sister Thérèse Castonguay, superintendent 
for the nursing education division of the 
department of education, anticipates that the 
workshops will aid existing faculty to pre- 
pare for the coming programs. 


Brockville Nurses Certified 
As Bargaining Unit 
After alìnost a year's wait, the Nurses' 
Association at Brockville General Hospital 
has been certified as a bargaining unit by 
the Ontario Labour Relations Board. The 
collective bargaining phase now can begin. 
The Nurses' Association proposed that the 


bargaining unit consist of all registered and 
graduate nurses, both full-time and part- 
time, who are employed by the Brockville 
General Hospital. The hospital proposed a 
unit of "all graduate nursing staff regularly 
employed in the nursing units, nursery, 
emergency department, operating room, cen- 
tral service and delivery room, save and 
except assistant head nurses and persons 
above that rank and daily basis relief nurses'" 
The unit as finally certified by the On- 
t<lrio Labour Relations Board includes all 
registered and graduate nurses at B.G.H. 
who are engaged in nursing care and in 
teaching, except head nurses and persons 
above the rank of head nurse, and those 
regularly employed for not more than 24 
hours a week. 
The Labour Relations Board further stated 
that aU registered and graduate nurses at 
B.G.H. who are engaged in nursing care 
and regularly employed for not more than 
24 hours per week "constitute a unit of the 
employees of the respondent appropriate for 
collective bargaining." 
The Brockville group is the third Nurses' 
Association in Ontario to be certified as 
a bargaining unit. Nurses at Riverview Hos- 
pital, Windsor, and at St. Joseph's General 
Hospital, Peterborough, were certified in 
1966. 


(Continued on page 10) 
MARCH 1967 



THE CLEAN WAY TO RINSE PATIENT UTENSILS 


AMSCQ-GRAY diverter valve 


Simple, clean, modern and effective. That describes AMSCO's popular 
Gray Diverter Valve. This chromed hoseless bedpan-emesis basin rinser is 
easily installed as part of the water closet. Both hands are free to hold 
the bedpan. The water closet flushes normally with the added feature of 
being equipped to spray-rinse patient utensils as soon as they become 
soiled. This immediate rinsing of each patient's utensil in the 
patient's room minimizes the possibility of cross contamination. 
In existing or new construction, installation takes only minutes 
and is accepted under the most rigid plumbing codes. 
There is no cleaner and safer way to rinse patient utensils. 
Write for brochure SC-367R 


;;
 
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I , 
I ' _ 1 
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ß: \ .-.- )1 
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2. 
FLUSH 


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3. 
RINSE 
UTENSIL 


)I 


4. 
RAISE 
SPRAY ARM 
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4' Al\I SC O 
AN AD 


-BRAMPTON ONTARIO 


" 


("".J 

... 

 
I. AMSCO-GRAY 
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Catalog number 7-C, 
type 2. 


, ' 
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-Q) 



a show of hands... 


news 


NEW FORMULA ALCOJEL, with 
added lubricant and emollient, will 
not dry out the patient's skin - 
or yours! 


r 


(Continued from page 8) 
P.E.I. Discusses Collective 
Bargaining 
A three-phase plan of action for better 
salaries and working conditions for Prince 
Edward Island's nurses was proposed by a 
Conference on Socio-economic Welfare in 
Charlottetown in mid-January. 
Representatives from all but two of the 
Island's hospitals met for a three-day session 
on collective bargaining for professionnal 
personnel. Miss Glenna Rowsell, nursing 
consultant, Canadian Nurses' Association, I 
chaired the conference, which was attended 
by about 30 persons each day. 
The provincial association is presently 
unable to bargain under the Labour Rela- 
tions Act in the province, and the nurses 
wished to ascertain the prospects for im- 
proving their economic position through 
collective bargaining. PEl's nurses are among 
the lowest paid in Canada. 
The conference drew up a plan of action 
for the coming year. The first step is to 
inform the members about labor legislation 
and to discover the kind of legislation want- 
ed. The association may then suggest the 
appropriate legislation and undertake to 
convince the provincial legislature of the 
practicability of the nurses' stand. 
"This three-phase attack - involvement 
of the members and promotion of educa- 
tion on industrial relations legislation, fol- 
lowed by an Association stand on the type 
of legislation suited to the needs of its 
nurses, followed by a concerted effort to' 
convince the legislature - is a most in- 
telligent and workable plan," reports Miss 
Rowsell. "It could eventually lead to more 
satisfied nurses - and better patient care." 


.... 



 


1 


nroves its sITloothness 


ALCOJEL is the economical, modern, 
jelly form of rubbing alcohol. When 
applied to the skin, its slow flow 
ensures that it will not run off, drip 
or evaporate. You have ample time 
to control and spread it. 
ALCOJEL cools by evaporation. . 
cleans, disinfects and firms the skin. 


:.' 


Your patients will enjoy the 
invigorating effect of a body rub with 
Alcojel .. the topical tonic. 


Jellied 
RUBBING 
ALCOHOL 


Gifts to Archives 
The Mary Agnes Snively Archives Col- 
lection at CNA House continues to grow. 
Three neW gifts to the collection have 
recently been received. 
A collection of books, including a set of 
Keating's Cyclopedia of the Diseases of 
Children, 1890, was received from the 
Miramichi Hospital, Newcastle, N.B. A 
print depicting a hospital scene in Middle- 
sex, England, in 1808 was donated by Lucy 
R. Seymer, author of various histories of 
nursing. 
The most recent addition was a memo- 
rial plate presented by the Medicine Hat 
Chapter of the Alberta Association of Re- 
gistered Nurses. 
CNA Librarian Margaret Parkin ex- 
pressed interest in further additions, espe- 
cially to the collection of early nursing 
caps. "We are anxious to receive the large 
and unusual ones worn in the 1800's," 
she said. "We would like to receive any 
distinctive Canadian ones for a special 
Centennial year display." 


ALCOJEL 


r . coolin 
efreshH,g... 9.. 


Send for a free sample 
through your hospital pharmacist. 


WITH 
ADDED 
LUBRICANT aøI 
EPt10LUENT 
BRITISH DIU8 HOUSES 
'DII1II1TD r,A1IJIIo 


ALCOJEL 



 THE BRITISH DRUG HOUSES (CANADA) LTD. 
Barclay Ave.. Toronto 18. Ontario 


10 THE CANADIAN NURSE 


MARCH 1967 



news 


Quebec Nurses 
Granted Certification 
The United Nurses of Montreal, which has 
organized within District No. 11 of the Asso- 
ciation of Nurses of the Province of Que- 
bec. reçently announced that the Quebec 
labour Relations Board has granted certi- 
fication to 10 groups of nurses in hospitals 
and health agencies. It is expected that the 
remaining 18 hospitals and agencies will 
receive certification as soon as the petitions 
are presented to the Labour Relations Board. 
The union includes nurses in both mana- 
gement and non-management positions. 
All nurses in the district, both French 
and English, are invited to become members 
of the association. The United Nurses of 
Montreal now has an office located at 3506 
University Street. Room 14, Montreal. 


DDS to Survey Nurses' Salaries 
The Dominion Bureau of Statistics will 
conduct a survey of salaries of graduate 
nurses employed in the public general and 
allied special hospitals of Canada. 
The survey, to be carried out this spring, 
is being undertaken with the active sup- 
port of the Canadian NUises' Association 
and the Canadian Hospital Association, and 
with consultation from the Department of 
Manpower and Immigration. 
It is expected that survey results will 
be available in the summer in a published 
report by the Bureau. Salary data will be 
presented according to the graduate nurses' 
employment category (directors, supervi- 
sors, head nurses, teachers, general duty), 
their lay or religious status, and whether 
they are currently registered or not. The 
survey questionnaire will be designed so 
that hospitals will be able to provide the 
data from payroll or personnel records with 
a minimum of effort. 
The Canadian Nurses' Association, with 
the support of the Canadian Hospital As- 
sociation, requested the survey. Salaries 
of many professional types are available 
in Canada but nurses, of whom so many 
are employed in hospitals, do not have any 
valid salary information that can be com- 
pared from region to region in Canada. 
The Dominion Bureau of Statistics has 
agreed, therefore, to approach hospitals in 
Canada and obtain from them the salary 
information from payroll data as of Feb- 
ruary 28, 1967, for all full-time personnel 
employed in the nursing categories out- 
lined. 
All graduate nurses who are employed 
on a full-time basis are to be included in 
this survey. If a nurse is employed in a 
dual position, her entry in the position in 
which she spends the major portion of her 
time will be recorded. 


MARCH 1967 


Space Suits For Nurses 


NUl"'ies worklOg in the operating rooms 
of the new 300-bed Riverside Hospital of 
Ottawa are becoming used to being teased 
about their "space suits." It is true, how- 
ever, that their two-piece trouser-suits with 
the built-in boots do resemble costumes 
from a science-fiction TV serial. 
The use of the oc<:lusive garb is a part 
of a two-year controlled federal-provincial 
research program on control of infections 
in operating rooms. 
Previous studies, such as the one carried 
out at the Barnes Hospital, St. Louis, have 
shown that the perineum, thighs, and feet 
are primary sources of viable bacteria and 
that these organisms become airborne in 
the course of normal activity. The neck, 
arms, and waist openings are apparently not 
important as sites for the escape of skin 
organisms. 
Conventional operating room dress per- 
mits the escape of skin bacteria from the 
lower extremities, so the staff at River- 
side are using a trouser and blouse outfit. 
The one-piece trouser-shoe outfit is made 
of an all-cotton tightly-woven fabric; a tie 
at the ankle provides for length adjustment. 
The shoe has the conductive sole. The tunic 
is three-quarter length with back fastenings 
and is made of regular cotton. A special 
over-boot is worn in the theatre as addi- 
tional protection. 
The trouser-suits are worn only in the 
theatre section of the hospitat. No one 
other than the operating room staff in their 
specially designed outfits and the patients 
ready for surgery are admitted to the 
operating room areas. 
Miss Olive Brissett, a graduate of Wan- 
.stad Hospital, London, England, is shown 
modeling the outfit for THE CANADIAN NURSE. 


/ 
. 


þ 


.....-
 



 


" 


Nurses Serve Abroad With 
External Aid 
A reputation for "quality, professionalism 
and flexibility" has been earned by Cana- 
dian nurses, who represent 60 percent of 
those serving abroad under Canada's Ex- 
ternal Aid Program. 
Whether as a staff nurse in Vietnam, a 
pediatric nurse in Tunisia, or a nursing 
instructor in Trinidad, the Canadian nurse 
is playing an important part in the External 
Aid program. 
As part of its program the External Aid 
Office fills requests from various under- 
developed countries for medical personnel. 
A file in the International Health Divi- 
sion of the Department of National Health 
and Welfare contains the personal history 
forms of nurses interested in serving abroad. 
From this file and through consultations 
with the Canadian Nurses' Association and 


the university schools of nursing, Dr. B.D.B. 
Layton, principal medical officer, is able 
to fill the requests for medical person- 
nel. 
Salaries are arranged to be as attractive 
as possible. Above a basic salary, which 
is commensurate with World Health Organ- 
ization and Pan American Health Program 
salaries, Canada's External Aid Program 
provides a non-taxable overseas allowance. 
To keep the program from defeating its 
purpose. a five-year maximum time limit 
has been set on overseas service. "In theory 
a country is setting out its own health 
plan," said Dr. Layton. "We provide tem- 
porary help for the country, not careers 
for ourselves." 
In most cases, the Canadian nurses help 
to staff existing hospitals or schools of 
nursing. In Tunisia, the Canadian Govern- 
ment has undertaken a different type of 
THE CANADIAN NURSE 11 



Public Support Needed For 
Psychiatric Programs 
Voluntary organizations in mental hea1th 
services are neglected, according to C.A. 
Roberts. executive director of the Clarke 
Institute of Psychiatry in Toronto. 
Dr. Roberts, who presented the first an- 
nual C.M. Hincks Memorial Lectures at the 
University of Ottawa's Faculty of Medicine 
in February, appealed for more public sup- 
port in mental health programs. "Where 
there is public apathy," he said, "poor health 

ervices result." 
Dr. Roberts pointed out that voluntary 
organizations can be very effective in chang- 


news 


project in agreement with the Tunisian 
government. The Hôpital d'Enfants in Tunis 
is being operated by a staff of 49 Canadians 
who fill positions as medical advisors, 
pediatric nurses, radiologists. and physio- 
therapists 
The challenges and opportunities that 
the External Aid Program offers are varied. 
Canadian nurses have become international- 
ly known through their readiness to part- 
icipate in all aspects of the program. 


/ 


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\ 


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.' 


, 
I 


 

 


2 



 


.Prlces quoted are Suggested Retail Prices 


For name of your ne.,e.1 d..ler. write: 
NATURALIZER DIVISION, BROWN SHOE 
COMPANY OF CANADA. LTD.. PERTH, ONTARIO 


12 THE CANADIAN NURSE 


ing public attitudes toward mental illness 
and in removing the stigma that still sur- 
rounds this type of illness. 
The Hincks Memorial Lectures, a tribute 
to Dr. Clarence M. Hincks, founder and 
first director of the Canadian Mental Health 
Association, will be presented annually in ' 
an Ontario university having a medical 
school. 


Invitations Available For 
Expo Attraction 
A series of 28 lectures to be presented 
by internationally known experts in their 
fields will be a feature attraction at Expo 
67 this year. 
Of special interest to nurses will be lec- 
tures by Sir Macfarlane Burnet, Nobel 
Laureate (Medicine) from Australia, (June 
12th); Dr. William Barry Wood Jr., Direc- 
tor of The Johns Hopkins University Depart- 
ment of Microbiology, (June 19th); and Mr. 
K. Helveg Petersen, Authority of Adult Edu- 
cation from Denmark, (June 26th). Other 
topics will range from "Development Trends 
in Contemporary Literature" to "Orient 
Pearls in the World Oyster." 
The lectures, sponsored by Noranda Mines 
Linùted, will be delivered at the DuPont 
of Canada Auditorium located On the site 
of the Exhibition - lle Sainte-Helene. 
The modern auditorium is completely 
equipped for the simultaneous translation 
of lectures into either English or French. 
The lecture by Academician Mikhail ShOo 
lokhov, to be delivered in Russian, will be 
simultaneously translated into both English 
and French. 
Attendance at any of the one-hour lec- 
tures is by special invitation only. Appli- 
cations for invitations, or requests for in- 
formation, should be sent to Mr. D. Hunka, 
Organizing Secretary, Science Programme, 
Expo 67, Mackay Pier, Montreal, P.Q. Ap- 
plications, to be treated on a first-come- 
first-serve basis, can be accepted only in 
writing. 


Canadian Doctors Visit China 
At the invitation of the Chinese Medical 
Association three Canadian doctors visited 
the People's Republic of China for a five- 
day observation tour of Canton and Peking 
health facilities. 
Dr. R. K. C. Thompson, President of 
the Canadian Medical Association; Dr. 
Walter MacKenzie, Dean, Faculty of Me- 
dicine, University of Alberta; and Dr. A. 
F. W. Peart, General Secretary, Canadian 
Medical Association, visited in mid-Novem- 
ber to observe medica1 education, medical 
research and medical practice in China. 
The Chinese Medical Association had 
arranged for the visas for the delegation, 
and planned a tour that included visits to 
the Bethune Orthopedic Hospital (named 
after Dr. Norman Bethune, a Canadian 
physician who took part in the revolu- 
tionary war and is considered a Chinese 
hero), various institutes of the Academy 
MARCH 1967 



news 


)f Medical Science of China, the Peking 
\1edical College, the Red Star People's 
:ommune, and the Canton Medical School. 
Dr. Peart reported that the Canadian 
Jelegation was impressed with the friend- 
,iness of the Chinese doctors and their 
Issociates, and their desire to have further 
;ontact with Canadian doctors. "Informa- 
:ion was given freely," Dr. Peart said. 
'and we were not curtailed in taking pic- 
lUres. Although we deliberately avoided 
:liscussions about their revolution and the 
::ommunist philosophy, which is comple- 
tely contrary to our way of life in Ca- 
nada, we all felt that further exchanges 
between the doctors of our two countries 
would be usefuL" 


.::;rant Approved for Ontario 
tHospital 
A federal grant of $115,053 for the 
I.O.D.E. Memorial Hospital in Windsor 
has been announced by National Health 
and Welfare Minister Allan J. MacEachen. 
The grant will assist the construction of 
an addition to the present hospital build- 
ing. The addition, to be known as the 
Osmond Wing, will consist of two single 
story units. The two units will provide 52 
beds for the care of psychiatric patients, 
as well as space for community mental 
health services and teaching areas. 
Completion of construction is expected 
this month. 


'WHO, UNICEF Try 
'New X-ray Units 
New. simplified x-ray units specially 
designed for use in rural health centers in 
less developed countries or as stand-by 
equipment in large hospitals are being test- 
ed by the World Health Organization. 
Cooperating in this venture are the United 
Nations Children's Fund (UNICEF) and 
leading manufacturers of x-ray equipment. 
Prototypes of different possible machines 
have been supplied by UNICEF to WHO 
for field trials in the Republic of the Congo 
(Brazzaville), Kenya. and Lesotho. 
X-ray machines are important tools in 
mass campaigns against tuberculosis and in 
other diagnostic work. However, the ma- 
chines now being manufactured are primarily 
designed for use in hospitals and health 
centers of technically-developed countries 
and have been found too complicated for 
operation in rural areas of developing coun- 
tries. Because of the lack of trained per- 
sonnel to operate the machines or the meager 
or non-existent service facilities, units in 
many hospitals are out of order most of 
the time. 
Under the technical guidance of medical 
radiographers and physicists, WHO drew up 
specifications for a simple, multipurpose ma- 
MARCH 1967 


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.. 
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--- 


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\ 
Nurses attending the Conference on Pediatric Nursing at the Hospital for Sick 
Children toured the ward areas to see current equipment and procedures. 


chine for use in these rural health centers 
and urban areas of developing countries. Ir 
the design, precautions have been taken 
against the possibility of radiation damage 
to the population. WHO anticipates requests 
from governments for the training of x-ray 
technicians and operators as a result of this 
trial. 
This investigation is of great value to all 
countries where the servicing and repair of 
x-ray apparatus present a problem. 


Outbreaks of Measles and 
Scarlet Fever in Quebec 
Measles and scarlet fever are currently 
approaching epidemic proportions in some 
regions of Quebec. The director of health 
for Quebec city, Dr. Jacques Roussel, has 
declared that the number of cases in his 
region is the highest in 10 years. The 
provincial minister of health is giving 
special attention to case-finding and treat- 
ment of these two diseases. 
Dr. A.R. Foley, director of the Epide- 
miology Service of the Department of 
Health, has pointed out that scarlet fever 
usually strikes children from 5 to 15 years 
of age. Even in a mild form the disease can 
cause permanent disability if not treated. 
At the early signs of scarlet fever, such 
as sore throat and pyrexia, it is advisable 
to consult a physician. Antibiotic and pro- 
phylactic treatment is recommended for 
those children who have had contact with 
the disease. 
Measles is characterized by cold symp- 
toms followed by a rash. In children under 
three years, the disease is often complicated 
by bronchopneumonia. 
Some doctors recommend administration 
of anti-measles vaccine, but mass vaccina- 
tion programs do not appear to be the ideal 
solution at the present time. 


.. 
. 


. 


.. 


- 


J 
c

' I 




 


( 


Pediatric Nursing Conference 
To inform, to up-date, to assist through 
talks, discussions and demonstrations - 
these were the objectives of the three-day 
Conference on Pediatric Nursing held early 
in December at the Graduate Nurses' Resi- 
dence of the Hospital for Sick Children, 
Toronto. 
Sponsored by the Hospital for Sick 
Children Department of Nursing, the con- 
ference demonstrated techniques and prac- 
tices currently being developed and used 
to ensure comfort and safety in the care of 
young patients. Sixty-two nurses from 
throughout Ontario attended the continuing 
education session. 
Displays were set up by each of the 
six participating areas: recreation and 
volunteers; emergency; intensive care; new- 
born and premature; medicine - isola- 
tion, and the committee for control of 
infection; and surgery - including physio- 
therapy, occupational therapy and dietary 
departments. 
The conference was designed to improve 
the nurses' competence in such areas as 
the hospitalized child and his family; im- 
portance of play for the hospitalized child; 
emergency nursing care of newborns and 
prematures; nursing care in a pediatric 
emergency department; factors to consider 
in creating a safe environment for chil- 
dren; nursing in the intensive care unit; 
and meeting the needs of the long-term 
patient. 


Grants for Multiple Sclerosis 
Research grants totalling $81,994. were 
announced early in January by the Multi. 
pIe Sclerosis Society of Canada. 
Headed by Dr. John M. Silversides of 
Toronto, the Society's Medical Advisory 
Board meets annually to consider applica- 
THE CANADIAN NURSE 13 



news 


tions from scientists at Canadian univer- 
sities and hospitals. After careful scrutiny, 
grants are awarded to those projects con- 
sidered most appropriate. The research pro- 
gram is coordinated with other areas of 
neurological research in Canada, the United 
States and Great Britain. 
Five Quebec grants, four of them to 
McGill University and the other to the 
University of Montreal, totaled $39,500.00. 


YES! 


you can get pediatric 
urine specimens easily, 
every time 


with Hollister's new 


U-BAG 


Those hard-to-get urine specimens from 
infants and very young children are not 
hard to get with the Hollister U-Bag. The 
U-Bag makes it easy and certain, elimi- 
nates backlog of specimen orders, gets 
fresh urine in sufficient volume for any lah- 
oratory procedure. The U-Bag fits girls as 
well as boys and is won' with comfort and 
security, with or without a diaper. Check 
the list of benefi ts, then let us send you 
some U-Bags for your own evaluation. 
Write, using hospital or professional 
letterhead, for free samples and ordering 
informa tion. 


The Holll.8ter V-Bas 
fit. R.rls and boys 
with equal eaie. 


f j-IolLIsTER:: 
Il 
HOLLISTER LTD., 160 BAY ST., TORONTO 1, ONT. 
14 THE CANADIAN NURSE 


Four othel grants were announced to the 
Hospital for Sick Children, Toronto, the 
University of Western Ontario, the Uni- 
versity of Saskatchewan, and the Univelsity 
of Toronto 
To science, multiple sclerosis remains 
the greatest unsolved neurological problem 
of our time. There is no cure, not even 
a definite knowledge of its causes. How- 
ever, the disease has struck an estimated 
30,000 Canadians, mostly in the 18-45 year 
age group. Among the symptoms of MS 
are blurred or double vision, tremors, loss 
of coordination, staggering or stumbling 
gait, speech difficulties, numbness. extreme 


"1 ... 
.n 


& 


H 
E 


.
T 
, 


Fits boys and girls with equal ease 
Quick and simple to apply 
Double-chamber design isolates 
specimen from child's sensitive skin 
"No-flowback" valves prevent urine 
from backmg up when bag is tipped 
No spilling. . . so body casts anll low 
surgical wounds remain dry 
Specimen IS protected from fecal 
contamination 


Urine stays in the bag. . . can 
be sent directly to lab without first 
being drained mto receptacle 
Surgical adhesive holds bag in place 
without tape 
Bag rests comfortably between child's 
thighs. . . gives complete freedom 
of movement 


Large capacity enables total-volume 
collection 


Available either sterile or non.sterile 


Completely disposable after use 


weakness and fatigue, and partial or com- 
plete paralysis. 
The Multiple Sclerosis Society of Canada 
was founded 18 years ago and by the end 
of 1967 will have allocated $763, I 82.88 
for research and fellowship grants in an 
effort to determine the cause and possible 
treatment for this baffling neurological dis- 
order. Additionally, through its 35 regional 
Chapters staffed by volunteers, the Society 
provides a Patients Services Program 10 
patients and their families. Quebec Chap- 
ters of the Society are active and the MS 
Society forms a part of the Combined 
Health Appeal of Greater Montreal. Head 
Office of the Society was recently trans- 
fered from Montreal to Toronto. 


New Vaccination Regulations 
A new International Certificate of Vac- 
cination booklet has been in use since 
January I, 1967 for all vaccinations per- 
formed for international travel. The re- 
vised form includes changes in the small- 
pox and yellow fever certificates as amended 
by the Eighteenth World Health Assembly 
in May, 1965. 
The International Certificate of Vacci- 
nation or Revaccination against Smallpox 
requires the physician to indicate that a 
vaccine that meets the World Health Or- 
ganization's requirements was used. The 
origin and batch number of the vaccine 
must be recorded. 
The International Certificate of Vaccina- 
tion or Revaccination against Yellow Fever 
was amended 10 extend the validity of the 
certificate from 6 years to 10 years. Cer- 
tificates already in use are automatically 
extended to be valid for 10 years. 


Hospital Infection Kit Part II 
Now Available 
Part II of an information kit on con- 
trol of hospital infections has been released 
by the Ontario Hospital Association. 
The material up-dates the work of the 
Canadian Council on Hospital Accredita- 
tion, includes a comprehensive section on 
dietary department involvement, and in- 
cludes new information on infection control 
in laundry departments. A copy of an in- 
fection reporting form currently in use in 
a member hospital is attached. 
Part I of the material on infections con- 
trol was prepared in July 1966 in response 
to needs revealed in the book The Control 
of Infections in Hospitals, by W. H. Le 
Riche, C. E. Balcom, and G. van Belle. 
The book reported on a survey of hospitals 
in Ontario and revealed problems in the 
areas of infection control. 
Since that time the Ontario Hospital As- 
sociation has undertaken educational ser- 
vices, including the publication of these 
kits, to acquaint members with the details 
of how an infection control program can 
be instituted. 


MARCH 1967 



news 


Cobalt Medications Withdrawn 
From Market 
The U.S. Federal Food and Drug Ad- 
ministration in Washington announced in 
mid-January the removal from the market 
of medications with a cobalt base. These 
medications were used in the treatment of 
certain types of anemia. Manufacturers 
have complied with this decision pending 
the results of further studies on the ef- 
fectiveness of the products. 
In Canada, the same medications were 
withdrawn from the market on December 
27th following deaths due to cardiac failure 
in drinkers of beer that had been made 
with cobalt salts. 


Quebec Interns and Residents 
Get Better Salaries 
The interns and residents of Quebec hos- 
pitals, who had resorted to "study days" on 
January 31 and February 7 to back demands 
for better salaries, have accepted salary in- 
creases offered by the provincial govern- 
ment. 
Interns who were receiving $3,060 per 
year will get $3,770; final-year residents 
who received $5,160, will get $6,170 under 
the new agreement. 
The residents and interns, who had re- 
fused several previous offers from the 
government, accepted the final offer on the 
condition that increases will be brought in 
line with those of their Ontario colleagues 
if the report of the Castonguay Commission 
has not been submitted by July I, 1967. 
A commission under M. Claude Caston- 
guay has been set up to inquire into health 
and social welfare in the province. The in- 
terns' group is preparing a brief for the 
Commission that will outline the grievances 
of the interns and residents, and which is 
intended to serve as a basis for future 
negotiations. 


u.S. Dermatologist Speaks Out 
Neither parents nor teenagers, but priv- 
ate physicians, are "contributing most" to 
the increasing venereal disease problem in 
the United States. 
So says Arthur C. Curtis, M.D., Chair- 
man of The University of Michigan's 
department of dermatology. 
In an editorial in the current University 
of Michigan Medical Center Journal, Dr. 
Curtis says incidences of infectious syphilis 
and gonorrhea are continuing to increase, 
although fewer private physicians are re- 
porting cases to health departments. He 
further asserts that those suffering most are 
the nation's young people. 
MARCH 1967 


"Our children are our most important 
asset," points out Dr. Curtis. "We should 
do all we can to make them knowledgeable 
about those things that may harm them, 
and do all we can to make this information 
possible for them to obtain." 


year and hence infect more and more 
young people." 
Dr. Curtis believes physicians should 
explain the serious nature of the problem 
with the patient, enlisting the patient's 
support in reporting the case. 
"Physicians who treat V.D. can be good 
epidemiologists but they don't have the 
time or the experience to seek out contacts." 
Every city, state or county health 
department has trained workers who are 
expert in finding infectious venereal disease 
and bringing it to treatment, Dr. Curtis 
explains. "Why don't we use them?" 


Recommending more V.D. instruction in 
schools, Dr. Curtis says that by treating 
and not reporting, "we physicians in priv- 
ate practice are the ones who are contribut- 
ing most to this infectious venereal disease 
problem among our young people. By 
treating and not reporting, we are allow- 
ing an infectious disease to increase each 


ONE-STEP PREP 


with 
\ FLEET ENEMÞ: 
single dose 
disposable IlII it 
FLEET ENEMA's fast prep time obsoletes soap and 
water procedures. The enema does not require warm- 
ing. It can be used at room temperature. It avoids the 
ordeal of injecting large quantities of fluid into the 
bowel, and the possibility of water intoxication. 
The patient should preferably be lying on the left side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. Left 
"""t
 colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. If a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
And afterwards, no scrubbing, no sterilisation, no 
preparation for re-use. The complete FLEET ENEMA 
unit is simply discarded! 
Every special plastic "squeeze-bottle" contains 41f2 
fl. oz. of precisely formulated solution, so that the 
adult dose of 4 fl. oz. can be easily expelled. A patented 
diaphragm prevents leakage and reverse flow, as well 
as ensuring a comfortable rate of administration. 
Each 100 cc. of FLEET ENEMA confains: 
Sodium biphosphate . 16 gm. 
Sodium phosphate. 6 gm. 
!-or our brochure: "The Enemo: Indications and Techniques", 
containing full information, write to: Professional Service 
Department, Charles E. Frosst & Co., P.O. Box 247, 
Montreal 3, P.Q. 


...-- ..- 


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.........- ...
 
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(!)Registered trode mark. 


A QUALITY PHARMACEUTICALS 
J..ow 
E;.
&Co. 

 IIO"'RE:AL CANADA 
'--- FDUNDlD IN CANADA IN 18f19 


THE CANADIAN NURSE 15 



news 


AMA Supports 
Nursing Salary Raise 
A "significant improvement in the in- 
come of the registered nurse" was called 
for by delegates to the American Medical 
Association's recent biannual session. 
The House agreed with the Board of 
Trustees and AMA's Committee on Nur- 
sing which supports the need for a signi- 
ficant improvement in the income of the 
registered nurse. They recognize that there 
will be considerable variation in compen- 
sation depending upon the prevailing local 
conditions, training, experience, and degree 
of delegated responsibility. 
The House also voted to continue to 
support in principle all current nationally 
approved educational programs for nurses. 
It noted that the American Nurses' As- 
sociation and the National League for 
Nursing have called for nursing education 
to take place in colleges and universities. 
Support for the nurses' salary raise was 
also voiced in an editorial in the Decem- 
ber 12 issue of The AMA News, a weekly 
newspaper published by the American 
Medical Association. The editorial said: 


Facts about 
Registered 
Nurses in 
Canada 


"Overworked and underpaid nurses have 
been given support for better wages and 
working conditions by the House of Deleg- 
ates of the AMA. 
"The House noted that the American 
Nurses' Association in June adopted a 
national salary goal of $6,500 for registered 
nurses beginning practice. But the House 
agreed with the report of the Board of 
Trustees and the Committee on Nursing 
which questioned such a national salary 
goal, establishing a minimum rate of com- 
pensation for the entire country. 
"A salary for registered nurses should 
be controlled by economics and the supply 
or demand in the part of the country 
where the nurse is employed. There is 
considerable variation in compensation 
depending upon the prevailing local condi- 
tions, training, experience, and the degree 
of delegated responsibility. 
"The ANA's goal was adopted in the 
belief that low salaries seriously hamper 
efforts to recruit nurses and to keep nurses 
in practice. In an interview printed in the 
November 28 issue of The AMA News, 
Jo Eleanor Elliott, RN, president of ANA, 
said many nurses with current licenses are 
not working because it is not economically 
feasible. 
"'As long as these inactive nurses keep 
their licenses current, there is a potential 
to alleviate the nurse shortage,' she said. 


Turnover Rate 


'The ANA is making a major effort to at- 
tract these inactive RNs back into nursing. 
But they must be given the proper motiva- 
tion - including better wages and working 
conditions - to make it worth their while." 


Tooth Transplantation 
Possible 
A tooth that has grown in a wrong posi- 
tion can now be extracted and transplanted 
according to a new method practiced by 
Swedish dentist Dr. Karl-Erik Thonner at 
the Stockholm County Clinic of Ortho- 
dontics, Näsby Park, Sweden. While keep- 
ing the tooth alive in the patient's own 
blood serum during surgery, Dr. Thonner 
has operated on some 30 patients with good 
results. 
"It was surprising even to us when we 
found out that this was possible," Dr. Thon- 
ner says in a Stockholm newspaper inter- 
view. "When we started, we used to give 
the tooth a root filling after it had been 
transplanted. Then we discovered that it was 
rossible to keep the nerve functions alive in 
the patient's own blood serum during sur- 
gery. .. 
Usually only 15 minutes are required to 
prepare the insertion of the tooth. It has, 
however, been possible to keep the tooth 
alive up to at least one hour, the doctor 
reports. The operation proper takes about 
an hour to perfonn. 


Graph shows turnover rate of full-time general duty nurses in public general 
hospitals in Canada, 1964. The turnover rate is a ratio of leavers to stayers. 
In 1964, the turnover rate for full-time general duty nurses in public general 
hospitals in Canada was 61 percent. This means that the number of resignations 
during the year was more than one-half of the average number employed 
during the year. 


Percent 
100 
. 
, 
. 
. , 
. I . I . . I 
Ø() .. -...... ... ..t.-.-...-..-- --f-- ---------t---------- f----------f---------.;-------- -t -. ---.. ---- 
. . I . . I 
I . I , . . 
. . I .. . 
I I I I. . 
6() ----....-...+---------f---.--.............--..------- 
.._.. .... ---------i---------t.....---- 
= , ; ! : 
, , , 
I I I I I . 
40 ---- - - - - - t - - - - - - -"t-----------t----------t----------t---------t---------t- u ------- 
I I . . . I . 
I . . . . I . 
. . I . I . . 
. I . . . . I 
I . I I . . . 
20 . - - - - - - --"'!'" - - -- - - - -
-----------!----------'!-.--------'!"---------'!---------'!-..------- 
. . I . . . . 
: : : : : : ! 
. . . . . I . 


Source: Research Unit, 
Canadian Nurses 
Association, 1966 


16 THE CANADIAN NURSE 


1- 
9 


10- 
24 


25- 
49 


50- 
99 


SIZE OF HOSPITAL (Number of beds) 


100- 
199 


200- 
299 


]()() - 
499 


500- 1000+ 
999 


MARCH 1967 



One day of walking down 
those long corridors... 
and standing on those 
cold, hard floors will tell 
you the importance of 
White Uniform Oxfords 
by Savage. 


Savage White Uniform Oxford shoes 
are made to take the strain off feet that 
walk and stand on hard floors day in. 
day out. They are expertly fashioned 
over well-designed lasts to give true 
comfort. Sanitized too for lasting fresh- 
ness. And wearing White Uniform 
Oxfords by Savage doesn't mean you 


I 


.. 


have to give up style for comfort. You 
get a choice of military or flat heels in 
a full range of sizes and widths. Sure 
you'll still be on your feet for hours every 
day. And the corridors won't be any 
shorter. But you'll find it much easier 
to carryon smiling in White Uniform 
Oxfords by Savage. 


WHITE U

ORMS 
by Sayage 


, 
, 
, . 
. 
..' . . . . 
..... . 


\ 


Style No. 
Style No. 57825 ,_ 
57815 


Style No. 1684& 


BB 1239 



names 


Margaret Ellen Cam- 
eron, a native of 
Winnipeg, Manitoba, 
recently assumed her 
new duties as execu- 
tive director of the 
Manitoba Association 
of Registered Nurses. 
A graduate of the 
School of Nursing of 
the Winnipeg General Hospital, Miss Cam- 
eron also holds both her baccalaureate 
and master of science degrees from Teachers 
College, Columbia University, New York. 
The new executive director has been 
active both in her profession and in various 
nursing organizations since the beginning 
of her career. She has held various posi- 
tions in the United States including that of 
school nurse in Connecticut, instructor at 
St. Luke's Hospital, New York and as- 
sistant director of the St. Luke's Hospital 
School of Nursing. 
Following her experience in the United 
States, Miss Cameron returned to her home 
town to become assistant director of nurs- 
ing at the Winnipeg General Hospital. 
The following year she became director of 
nursing, a position she held until 1963. 
Prior to her present appointment, she serv- 
ed three years as assistant administrator 
of the same hospital. 
Her membership in nursing organiza- 
tions, both provincial and national, included 
the chairmanship of the education com- 
mittee of the Manitoba Association of 
Registered Nurses. 
As executive director, Miss Cameron is 
"pleased to participate in an expanded 
program for the Manitoba Association of 
Registered Nurses," and looks forward "to 
working with my colleagues in its develop- 
ment." 


....- 


- 
- 


II 


Marie Fountain, born and educated in 
England, has been appointed administrative 
assistant (nursing) to Jean Milligan at the 
Ottawa Civic Hospital. 
Miss Fountain graduated from Central 
Middlesex Hospital School of Nursing and 
emigrated to Canada in 1957. Before mOv- 
ing to Ottawa in 1959 she worked at hos- 
pitals in Weiland, Ontario and Banff, Al- 
berta. 
At the Ottawa Civic, Miss Fountain 
worked as a head nurse and administrative 
supervisor before obtaining a diploma in 
nursing administration and education from 
the University of Ottawa in 1963. She is 
presently completing her requirements for 
her B.Sc. degree at the University. 
18 THE CANADIAN NURSE 


Pearl G. Morcombe 
is the new public 
relations officer for 
the Manitoba Associa- 
tion of Registered 
Nurses. 
Mrs. Morcombe 
graduated from the 
General H 0 s pit a I 
School of Nursing, 
Port Arthur, Ontario and is presently fol- 
lowing an extension course in executive 
administration at the University of Mani- 
toba. 
Mrs. Morcombe brings an impressive 
background in both nursing and public rela- 
tions to her new job. She spent three years 
in industrial nursing at MacDonald Air- 
craft in Winnipeg. From 1955 to 1958 she 
acted as. public relations and field services 
representative with the Manitoba Hospital 
Services Association in Winnipeg. From 
1958 to 1962 she was liaison officer for 
the Manitoba Hospital Commission. 
Prior to her new appointment Mrs. Mor- 
combe spent five years as assistant to the 
manager of hospital construction for the 
Manitoba Hospital Commission. 


... 



 


.... 


... 


.-Å. 


Wilhelmina Bell is 
the new director of 
nursing service at the 
General and Mar- 
ine Hospital, Owen 
Sound. A graduate of 
the Royal Victoria 
Hospital School of 
Nursing in Montreal, 
Miss Bell subsequent- 
ly studied nursing education at the Univer- 
sity of Toronto and followed 2 postgraduate 
course on psychiatric nursing at the New 
York Psychiatric Institute. 
She gained experience in both nursing 
and nursing education in the United States 
and Canada. At the Presbyterian Hospital, 
New York, Miss Bell served as a head 
nurse. Following this she worked as an 
instructor and a clinical supervisor at the 
Wellesley Hospital, Toronto, and the St. 
Catharines General Hospital, St. Catharines, 
Ontario. 
Back in the United States, at Durham, 
North Carolina, Miss Bell worked as coor- 
dinator for a school for colored practical 
nurses at Duke University School of Nurs- 
ing. 
Prior to her present appointment at the 
General and Marine Hospital, Miss Bell 
was director of nursing service at the 
Public General Hospital, Chatham, Ontario. 


1r'- 


Diane Yvonne Ste- 
wart, of London, On- 
tario, received a 
double appointment 
recently from the 
London Health As- 
sociation and the 

 University of Western 
Ontario. She was ap- 
pointed director of 
nursing service at the new University Hos- 
pital and also an associate professor, part- 
time, in the University of Western Ontario 
School of Nursing. 
Miss Stewart obtained her B.Sc.N. from 
Western and is currently completing re- 
quirements there for a master of science 
in nursing degree. A Canadian Nurses' 
Foundation Fellowship was awarded to 
Miss Stewart for 1966-67. 
Following graduation from Victoria Hos- 
pital School of Nursing in London, Miss 
Stewart attended the University of Toronto 
for one year. She then taught obstetrical 
nursing at the Victoria Hospital School of 
Nursing for two years. At that time she 
became a supervisor in the nursing service 
department and later assistant director of 
nursing at Victoria Hospital. 



 


Joanne Fyle, St. Thomas, Ontario, has 
been awarded the RNAO entrance bursary 
at McMaster University School of Nur- 
sing. 


Sharon Hanna, Dunnville, Ontario, has 
won the Niemeier Scholarship for high 
standing in third year maternal and child 
care nursing. 
Elizabeth Latimer, Hamilton, Ontario, 
is winner of the McGregor Clinic Scholar. 
ship for high set standing in third year 
medical-surgical nursing. 
Nancy Mcllwraith, Marathon, Ontario, 
has won the Niemeier Scholarship for 
highest standing in first and second year 
clinical nursing subjects. 


Irene Ashworth, 
former supervisor of 
the Ottawa Branch of 
the Victorian Order 
of Nurses, recently 
joined the national of- 
fice staff as a regional 
supervisor. 
Miss Ashworth, a 
graduate of the School 
of Nursing of St. Joseph's Hospital, Hamil- 
ton, Ontario, also holds a diploma in pub- 
lic health which she earned in 1959 from 



 


MARCH 1%7 



the University of Western Ontario and a 
diploma in supervision and administration 
from the University of Toronto. 
Before joining the Victorian Order of 
Nurses in 1957, Miss Ashworth did generaJ 
and private duty nursing at the Hamilton 
Civic Hospital and St. Joseph's Hospital, 
Hamilton, Ontario. She served as a staff 
nurse with the Hamilton Branch of the 
V.O.N. until 1963. The following year she 
became supervisor of the Ottawa Branch 
where she remained until her present ap- 
pointment as a regional supervisor. 


Lillian Mae Randall, a native of Van- 
couver, British Columbia, also joined the 
national office of the Victorian Order of 
Nurses as a regional supervisor. 
Miss Randall graduated from the School 
of Nursing of the Vancouver General Hos- 
pital in 1945 and served for one year as a 
staff nurse in the psychiatric ward of the 
same hospital. 
The following year she obtained her 
certificate in public health nursing from 
the University of British Columbia. 
In 1947 Miss Randall became a staff 
nurse for the Vancouver Branch of the 
V.O.N., and later the educational super- 
visor for the Vancouver Branch. 
In 1963 she obtained a certificate in 
public health administration and supervi- 
sion from the University of Toronto. 


At the end of 1966, Margaret E. Mac- 
donald retired from service at the Calgary 
General, the hospital she entered as a 
student nurse over 40 years ago. 
Born in New Brunswick, Miss Mac- 
donald came to Western Canada in 1919 
and entered the Calgary General Hospital 
School of Nursing in 1923. After her grad- 
uation in 1926, she began her career at the 
hospital. She gained experience as a staff 
nurse, private duty nurse, head nurse and 
nursing supervisor. 
At retirement she was evening supervisor 
in the convalescent-rehabilitation building 
of the hospital. 
Known affectionately as "Black Mac" 
since her school days, Miss Macdonald is 
"a person who always places others first." 
At the open house reception given in her 
honor before her retirement, Miss Mac- 
donald's 37 years of continuous service at 
the Calgary General Hospital were recogniz- 
ed by members of the hospital board and 
medical staff. 


Florence Taylor, associate director of 
nursing education, Brantford General Hos- 
pital since August, died suddenly Decem- 
ber 19, 1966. 
Her nursing experience has taken her 
through Canada, the United States, India, 
Korea, and Manchuria. 
Miss Taylor joined the staff of Brant- 
MARCH 1967 


I 


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Enaam Abou-Youssef, an instructor from the United Arab Republic, dIscusses 
CNA's public relations program with June Ferguson, public relations officer. 


On the homeward swing of a journey 
that began in February 1961, Enaam Y. 
Abou-Youssef visited CNA House in Ot- 
tawa, Wednesday, January 18, 1967. 
Miss Abou- Youssef, a nurse from the 
United Arab Republic, attended the Uni- 
versity of California School of Nursing 
where she obtained her master of science 
degree in 1963. She then enrolled in the 
doctoral program at Teachers College, 
Columbia University in New York. 
Miss Abou-Youssef is from Alexandria, 
Egypt. In 1960, she was in the second 
class to graduate from the first university 
nursing course established in the UAR at 
the Higher Institute of Nursing, University 
of Alexandria. Following this she was ap- 
pointed clinical instructor at the same 
institution. 
Miss Abou- Youssef said that the establish- 
ment of university schools of nursing in 
the UAR brought "more prestige and sta- 
tus" to the profession in her country. 
Miss Abou- Youssef is presently working 
on her doctoral project - a thesis on 
maternity nursing "focused on the respon- 


sibilities of the nurse to the family during 
the maternity cycle." She hopes that the 
thesis eventually will be translated into 
Arabic and published as a textbook to be 
used by the baccalaureate students in the 
Near Eastern Region. 
The book will be entirely new in its 
approach to maternity nursing as it does 
not include anatomy and physiology of re- 
productive organs or the mechanism of labor 
as complete units. 
During her visits to the Universities of 
Manitoba and Western Ontario, Miss Abou- 
Youssef gathered ideas for developing a 
different point of view for the master's 
program to be inaugurated at the University 
of Alexandria. 
On her return home this spring she will 
teach maternity nursing at the Higher In- 
stitute of Nursing. She is also involved 
in developing nursing activities, nursing 
education and nursing service throughout 
her country. 
Miss Abou-Youssef also admits she looks 
forward "to being waited on again" when 
she returns to her homeland. 


ford General Hospital, January 1966 as 
assistant director of nursing education. 


Canadian-born Helen Young, a widely 
known figure in American nursing, died 
recently at 92. 
Miss Young taught in an Ontario public 
school for 13 years before she entered the 
Presbyterian Hospital School of Nursing, 
New York, in 1909. In World War I she 
served at a hospital for the wounded in 
Juilly, France. 
In 1921, nine years after Miss Young 
became a nurse at the Presbyterian Hospi- 
tal, she succeeded Miss Anna C. Maxwell, 
the school's first director. 


In 1933 Miss Young became the first 
editor of Quick Reference Book for Nurses, 
and in 1937 she received Columbia Uni- 
versity's medal for excellence, awarded 
for service to the university. 


William A. Holland, administrator of the 
Oshawa General HospitaJ, was recently 
elected president of the Ontario Hospital 
Association for 1966-67. Mr. Holland has 
been a member of the Association's board 
of directors since 1959. As the first admi- 
nistrator to hold the top OHA post in five 
years, Mr. Holland succeeds Glen W. Phelps, 
a trustee of the OriIlia Soldier's Memorial 
HospitaJ. 


THE CANADIAN NURSE 19 



.. 


your 
Own 
hands: 


.... 


. 


" 


"' 


soft testimony to your patients' comfort 


Your own hands are testimony to Dermassage's effectiveness. Applied by your 
soft, practiced hands, Dermassage alleviates your patient's minor skin irritations 
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned 
skin; relieves dryness, itching and cracking. . . aids in preventing decubitus 
ulcers. In short, Dermassage is "the topical tranquilizer", , . it relaxes the patient 
. , , helps make his hospital stay more pleasant. 
You will like Dermassage for other reasons, too. A body rub with it saves your time 
and energy. Massage is gentle, smooth and fast. You needn't follow-up with 
talcum and there is no greasiness to clean away, It won't stain or soil linens or 
bed-clothes. You can easily make friends with Dermassage-send for a sample! 


Now available in new, 16 ounce plastic container with convenient flip-top closure. 


--. 


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c:5Ø LAKESIDE LABORATORIES (CANADA) LTD. 

 64 Colgate Avenue. Toronto 8, OntarIo 
MARCH 1967 


20 THE CANADIAN NURSE 



in a capsule 


Wine - the Chemical Symphony 
"Have a glass of this therapeutic adju- 
vant for the promotion of relaxation," your 
medicaHy-minded host may suggest some 
evening after supper. If you refuse, you 
may be turning down a "natura1 tranquilizer" 
of some fine old vintage. 
For those who need and excuse to drink 
wine, Dr. Sa1vatore P. Lucia, professor of 
medicine at the University of California 
School of Medicine, San Francisco. provides 
several sound therapeutic ones. 
Wine, he points out, has been used for 
more than 40 centuries as a safe tranqui- 
lizer and there is no reason it should not 
be used for this even today. Modem re- 
search has confirmed the age-old values of 
wine, he says. In his view, wine is a "natu- 
ral tranquilizer" while tranquilizing drugs are 
"artificia1 tranquilizers." 
Wine, says Dr. Lucia, is more than merely 
a1cohol. "Its many other ingredients bring 
it into the category of tranquilizers. Many 
studies of wine disclose that the ability of 
wine to reduce nervous tension is a result 
of the ability of its 'chemical symphony'" 
Numerous studies have shown "that wine 
gives far more sustained and gently tran- 
quilizing effects than does straight ethyl 
alcohol diluted with water to the same 
strength. " 
One leading possibility for use of wine 
as a tranquilizer is in the elderly, says Dr. 
Lucia. It can help them "cope with... ten- 
sions and live out a long span in peace and 
gratitude." One serving before a mea1 or 
two servings with a meal provide the desired 
tranquilization. 
"In the rush of rapid pharrrulceutical pro- 
gress, the ages-old established, inexpensive, 
and safe medicine called wine is apt to be 
forgotten," writes Dr. Lucia. "So, too, in a 
post-prohibition society, these ancient dietary 
beverages are still apt to be regarded over- 
emotionally and pseudo-moralistically by the 
physician. Yet, the long history of the use 
of wine in medical practice and the modern 
scientific research confirming its values are 
gaining the attention of increasing numbers 
of physicians." 


No Utopia for Nurses 
"In some Utopian tomorrow," says Mollie 
'Gillen of Chatelaine, (January 1967) nurses 
will be "freed at last from the tyranny of 
counting sheets, serving meals, making up 
empty beds and pushing wheelchairs." 
Unfortunately, she sees that tomorrow as 
a far distant one. 
MARCH 1967 


The nursing profession in Canada today, 
according to Mrs. Gillen, is characterized 
by "creaking mechanisms and archaic pat- 
terns" which, instead of improving are act- 
ing as deterrents to prospective student 
nurses. 
In fact, the percentage of high-school 
graduates entering nursing has declined 
sharply over the past twenty years. Only 
10 percent of girls from high schools are 
enrolling today (in 1951 it was 20 percent; 
in 1944, 25 percent), and "a continued drop 
is feared unless nursing is made more at- 
tractive as a career," she says. 
What exactly are the problems that beset 
nursing today? asks Mrs. Gillen. 
In answer to her own question, she places 
at the top of the list the shortage of nurses 
that keeps whole hospital wings closed and 
overworks existing staff. She also points out 
the shortage of teachers to train nurses and 
the proliferation of aides and helpers whose 
training and duties aren't clearly defined. 
Then there are antiquated hospital schools, 
where training is paid for by free labor. Not 
surprising, continues the author, is the grow- 
ing demand for promotion opportunities in 
clinical nursing, as well as in administration 
and teaching. Moreover, the profession is 
beset by internal conflicts for better pay, 
better working conditions and a more de- 
mocratic organization. 
Problems unfortunately are more plentiful 
and obvious than solutions. However, an 
Canadian provinces today at least recognize 
the need for shortening the diploma pro- 
gram, for providing opportunities for clinical 
specialization, and for rearranging salary 
levels. 
"With solutions slowly being found to the 
still-quite-bitter intramural arguments within 
the profession... nursing could be at the 
beginning of a new regime that safeguards 
the nurses in their rights as well as the 
public in its expectation of good service," 
concludes Mrs. Gillen. 


5,500,000 Still Puffing 
At least 1,000,000 Canadians did it. An- 
other 2,500,000 seriously tried but couldn't, 
and a further 3,000,000 didn't even attempt 
to break the smoking habit. 
Of the 1,000,000 regular cigaret smokers 
who successfully overcame the habit, most 
claimed "unspecified health reasons" as their 
reason for quitting. Others named coughing, 
throat irritation, bronchitis, family objec- 
tions, expense, and doctor's orders as res- 
ponsible. Low on the list came fear of 
cancer. 


Even those 5,500,000 brave Canadians 
who steadfastly hang onto the habit despite 
the odds, admit dissatisfaction with theIr 
smoking habits. These findings were the re- 
sults of a survey recently released by Hon. 
Allan J. MacEachen, Minister of National 
Health and Welfare. 
The study also shows that certain pro- 
vinces are more nicotine-prone than others. 
Regionally, British Columbia shows the high- 
est proportion of former regular smokers 
(49% of male and 17% of female non- 
smokers and occasional smokers were at one 
time regular cigaret smokers) and Quebec 
the smallest (30% of male and 8% of 
female.) British Columbia also shows the 
highest proportion (53%) of regular cigaret 
smokers who have tried to stop smoking, 
and Quebec the lowest (37%). 
Conducted among persons 15 years of 
age and over, the survey reveals that among 
present non-smokers of cigarets, 32% of 
the men and 9% of the women at one time 
were regular users. Attempts to break the 
smoking habit tend to be more common 
among those under 40. Women who have 
succeeded are most commonly found in the 
20 to 39 age bracket. Men who have stopped 
daily smoking are more frequently found 
among those 40 and over. 
A growing awareness of the dangers of 
cigaret smoking is reflected in the concern of 
the Department of National Health and 
Welfare with the smoking habits of Cana- 
dians. Annual surveys and comparisons of 
results are planned by the Department for 
the future. 


Vaccine Race 
A live vaccine against mumps appears 
to have been developed simultaneously - 
or almost simultaneously - in the East and 
in the West. 
The Russians claim that the first one was 
developed at the Pasteur Institute in Lenin- 
grad. This vaccine was tried out among all 
the children aged two to twelve in Pskov a 
regiona1 center nearby. There were onl; a 
few cases in the year following the vaccina- 
tion, although there had been mass out- 
breaks in the same region previously. 
In the U. S. a live attenuated vaccine 
(developed by Dr. Maurice R. Hillman and 
Dr. Eugene Buynak) was tested among 482 
Philadelphia school children. A great many 
cases of natura1 mumps occurred in the test 
community, whereas there were only two 
cases - both in school-age youngsters - 
among the vaccinated children. - Royal 
Society of Health Journal - Sept.-Oct. 
THE CANADIAN NURSE 21 



new products 


{ 


Descriptions are based on information 
supplied by the manufacturer and are 
pro
ided only as a service to readers. 


Specimen Container 
(PROFESSIONAL DISPOSABLE PRODUCTS) 
Description - A water-tight and odor- 
proof, eight-ounce laboratory specimen 
container made of shatterproof, opaque 
plastic. This container is supplied with a 
specially imprinted lid which simplifies 
writing identifying information. 
For additional information, write to 
Professional Disposable Products, Inc., 22- 
28 South Sixth Avenue, Mount Vernon, 
New York 10550. 


1 


&
,,'ORY SP.Fc/.. 
.$'. _ "'t;.. 


Norlestrin 1 mg. 
(PARKE-DAVIS) 
Description - A new, low-dosage (1.0 
mg.) form of the oral contraceptive, Norl- 
estrin, previously available only as a 2.5 
mg. tablet. Each tablet of Norlestrin 1 mg. 
contains norethindrone acetate I mg. and 
ethinyl estradiol 0.05 mg. 
Norlestrin I mg. is a progestogen- 
estrogen combination for control of con- 
ception. Like Norlestrin 2.5 mg., it contains 
norethindrone acetate and ethinyl estradiol 
but it contains only 1 mg. of the proges- 
togen. 
Dosage - Initial cycle: The first tablet 
is taken on the fifth day after onset of 
menstruation. The first day of menstrual 
flow is considered day one. Tablets should 
be taken regularly with a meal or at bed- 
time. After taking one tablet daily for 21 
consecutive days, no tablets are taken for 
7 days. Subsequent cycles: After the 7-day 
interval in which no tablets are taken, a 
neW course of 21 tablets is started regard- 
less of whether bleeding has finished or 
not. Each cycle consists of 21 days of 
medication and a 7-day interval without 
medication. 
Contraindications - This type of ther- 
apy (progestogen-estrogen combinations) is 
contraindicated in patients with, or with a 
history of, cancer (because of the estro- 
gen), preexisting liver disease, or a history 
22 THE CANADIAN NURSE 


of thromboembolic disorder. Oral contra- 
ceptives should not be used by nursing 
mothers, young women in whom epiphyseal 
closure is not complete, or women who 
have had a stroke, partial or complete loss 
of vision, diplopia or proptosis. The use of 
oral contraceptives containing progesta- 
tional agents should be avoided where preg- 
nancy is suspected. 
Side Effects - Break through bleeding, 
nausea, and diminished menstrual flow are 
the principal side effects considered to be 
drug related. 
For further information or to obtain the 
file booklet containing the basic prescrib- 
ing information, write Parke, Davis & 
Company, Ltd., P.O. Box 2100, St. Laurent 
Post Office, Montreal 9, P.Q. 


Flexitone 
(CYANAMID) 
Description - A new adjustable surgical 
binder for use with postoperative and post- 
partum patients. The Flexitone binder is 
designed to provide comfortable support 
without compromise of muscle tone. It will 
not roll, ride or chafe and provides enough 
"give" to allow freedom for the muscles to 
expand and contract. 
The binders are anatomically designed 
and sized for both male and female patients. 
They are lined for comfort and may be 
laundered repeatedly without loss of resi- 
liency. 
Uses - The Flexitone surgical binder is 
used after abdominal surgery, after normal 
delivery or caesarian section, for chest sup- 
port in fractures and surgery, and for back 
support. 


Cerevon-S 
(CALMIC) 
Description - Cerevon-S is a combina- 
tion of ferrous succinate 150 mg. and suc- 
cinic acid 110 mg. 


Indications - Used in the treatment of 
iron deficiency anemia. Compared to 
other methods of treating iron deficiency 
anemia, Cerevon-S showed a more rapid 
rate of hemoglobin rise and a higher final 
hemoglobin level after twenty weeks. It is 
also effective in some patients who do not 
respond to conventional oral iron. 
Dosages - One capsule t.Ld. between 
meals or as prescribed. When given be- 
tween meals, the period of maximum ab- 
sorption, Cerevon-S produces minimal intol- 
erance, although gastrointestinal disturb- 
ances, eg., diarrhea, constipation, heart- 
burn, can occur. 
For further information, contact Calmic 
Limited, 16 Curity Avenue, Toronto 16, 
Onto 


Ger-o-Foam 
(WINLEY-MORRIS) 
Description - Benzocaine 3%, methyl 
salicylate 30%, in a neutralized emulsion 
base containing volatile oils. 
Indications - Ger-o-Foam is an anesthe- 
tic analgesic foam used to increase mobility 
of limbs in musculo-skeletal involvements. 
The formulation permits penetration of 
the medicaments into the deeper structures 
underlying the skin to relieve pain and 
stiffness in rheumatoid and osteoarthritis; 
painful limbs following cerebrovascular 
accident; painful healed fracture, low back 
pam; sprains; etc. 
Directions - Apply to affected part 
and massage in gently. 
For information contact: Winley-Morris 
Co. Ltd., 2795 Bates Rd., Montreal 26, P.Q. 


Tussagesic 
(ANCA) 
Description - Each time-release tablet 
contains triaminic 50 mg., dormethan 
30 mg., terpin hydrate 180 mg., and aceta 
minophen 325 mg. 
Indications - For relief of symptoms of 
the common cold. Tussagesic decongests, 
relieves pain, breaks up cough and provides 
effective expectorant action. 
Dosages - For adults and children over 
12 years - one tablet, swallowed whole, 
in morning, mid-afternoon and at bedtime. 
Tussagesic is also available in suspension 
form. Both tablets and suspension can 
cause occasional drowsiness, blurred vision. 
cardiac palpitations, flushing, dizziness, 
nervousness or gastrointestinal upsets. 
For further information, contact ANCA 
Laboratories, 1377 Lawrence Ave., East, 
Toronto, Ontario. 


MARCH 1967 



dates 


April 27-29, 1967 
Registered Nurses' Association of Ontario, 
annual meeting. Royal York Hotel, 
Toronto. 


May 4-6, 1967 
St. Boniface Hospital, School of Nursing, 
25th Reunion of the 1942 Graduating 
Closs. Would members of the 1942 
graduating closs please write to 
Miss F.E. Taylor, R.N., 
10123-122 Street, Edmonton. 


May 8-12, 1967 
Notional League for Nursing, Biennial 
Convention. Theme: "Nursing in the Health 
Revolution." New York Hilton Hotel, 
New York City. 


May 16-19, 1967 
Alberto Association of Registered Nurses 
Annual Meeting, Chateau Lacombe, 
Edmonton, Alberto. 


May 19-21, 1967 
60th Anniversary reunion of the Royal 
Inland Hospital School of Nursing, 
Kamloops, B.C. For further information 
write: Mrs. Sylvia Lum, Suite "C", 
248 Victoria St., Kamloops, B.C. 


May 24-26, 1967 
Saskatchewan Association of 
Registered Nurres Annual Meeting. 
Saskatoon. 


May 24-26, 1967 
International Symposium on Electrical 
Activity of the Heart, London, Ontario. 
For further information write to 
Dr. G.W. Manning, Victoria Hospital, 
London, Onto 


May 29-31, 1967 
Operating Room Nurses' Fourth Ontario 
Conference, The Inn on the Park, 
Toronto, Ont. Sponsored by the Operating 
Room Nurses of Greater Toronto. Direct 
inquiries to: Mrs. Eleanor Conlin, R.N., 
437 Glen Pork Avenue, Apt. 309, 
Toronto 19, Onto 


May 31-June 2, 1967 
Registered Nurses' Association of Novo 
Scotia Annual Meeting, Sydney, N.S. 


MclY 31-June 2, 1967 
Registered Nurses' Association of British 
Columbia Annual Meeting, Bayshore Inn, 
Vancouver, B.C. 


MARCH 1967 


May 31-June 2, 1967 
New Bn.mswick Association 
of Registered Nurses Annual 
Meeting. The Playhouse, Fredericton. 


June 4-16, 1967 
University of Windsor, 6th annual 
residential summer course on alcohol and 
problems of addiction. Co-sponsored by 
the University of Windsor and the Alcohol 
and Drug Addiction Foundation of Ontario. 
Limited enrollment. Enquiries to: Director, 
Summer Course, Addiction Research 
Foundation, 24 Harbord St., Toronto 5, Onto 


June 5-8, 1967 
Atlantic Provinces Hospital Association, 
Annual Meeting. 


June 8-9, 1967 
Manitoba Association of Registered 
Nurses' Annual Meeting to be held 
in connection with the Western Regional 
Hospital Conference 


June 12-15 1967 
Canadian Dietetic Association, 32nd 
Convention, Château Laurier, Ottowa. 


June 18-21, 1967 
Ottowa Civic Hospital, Centennial Home 
Coming. Alumnae or former associates of 
the Ottowa Civic Hospital who are 
interested in the program should write to: 
Executive Director, Ottowa Civic Hospital. 


June 24, 1967 
St. Joseph's Hospital School of Nursing, 
Toronto, Centennial Reunion. Any graduates 
who do not receive alumnae newsletters, 
please send nome and address to: 
St. Joseph's Hospital School of Nursing 
Alumnae, 30 The Queensway, Toronto 3, 
Ontario. 


July, 1967 
75th Anniversary, Nova Scotia Hospital 
School of Nursing, Dartmouth, N.S. All 
interested graduates please contact 
Mrs. G. Varheff, 20 Ellenvale Ave., 
Dartmouth, N.S. 


September 15-17, 1967 
70th Anniversary, Aberdeen Hospital School 
of Nursing, New Glasgow, Novo Scotia. 
Write: Mrs. Allison MacCulioch, R.R. #2, 
New Glasgow, Pictou Co., Novo Scotia. 


NEW FOR HOSPITALS 


the 
Autolope 


It responds 
to heat 
trea tment. 



 
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.. 


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". 


..... 


, 


....
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- -,.........

"... 

 ',.s 
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When the contents of the enve- 
lope are completely sterilized by 
the Autoclave, the indicator ink 
changes colour. This unique Gage 
Autolope is security folded and 
pressure-sensitive gummed to 
prevent contamination. It was de- 
veloped for Autoclaving with the 
help of medical, paper, printing, 
adhesive, and chemical experts. 
The Autolope is available now in 
an approved range of sizes. An- 
other new envelope idea from. . . 


Envelope Division 


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enjoys the business it's in. 
Envelopes. Stationery . Textbooks 
TORONTO. MONTREAL.VANCOUVEF 
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THE CANADIAN NURSE 23 



Plan Now For 


Basic Sciences 
BASIC PHYSIOLOGY AND ANATOMY 
By Ellen E. Chaffee, R.N., M.N., M. Lilt.; and Esther 
M. Greisheimer, Ph.D., M.D. 
Physiology and anatomy are skillfully fused in this text 
designed for the freshman nursing student. Realistic 
clinical applications clarify scientific principles. Chap- 
ters are amplified by summaries and questions. Testing 
program for instructors' use is available upon request. 
656 Pages 371 lIlustrations, 45 in color, plus Videograf 
1964 $7.75. 
LABORATORY MANUAL IN 
PHYSIOLOGY AND ANATOMY 
By Ellen E. Chaffee, R.N., M.N., M. Lilt. 
Organized into twenty-four laboratory units with em- 
phasis on the normal human body. Practical applica- 
tions animate the principles. Study questions follow 
each lesson. 260 Pages lIlustrated 1963 $2.60. 
PHYSIOLOGY AND ANATOMY: 
With Practical Considerations 
By Esther M. Greisheimer, Ph.D., M.D.; with the 
assistance of J. Robert Troyer, Ph.D. 
A text designed to meet the needs of students in general 
courses as well as those directly applied to nursing. 
Physiology and anatomy are featured in separate chap- 
ters according to body systems. Content is enlivened 
by practical considerations pertaining to broad health 
problems. 894 Pages 430 lIlustrations, plus Videograf 
8th Edition, 1963 $9.50. 
ESSENTIALS OF CHEMISTRY 
By Gretchen O. Luros, M.A.; and Jack C. Towne, 
Ph.D. 
Provides the student with a strong foundation in inor- 
ganic, organic and particularly physiologic chemistry. 
New data incorporated in the 7th Edition includes car- 
bohydrates, lipids, proteins, metabolism, nucleic acids, 
enzymes, vitamins, inorganic body requirements and 
hormones. 356 Pages 101 lIlustrations 7th Edition, 
1966 $6.50. 
INTRODUCTION TO MEDICAL PHYSICS 
By J. Trygve Jemen, Ed. D. 
A clarification of the physical principles underlying 
nursing procedures and an explanation of the scientific 
framework upon which qualified nursing activities de- 
pend. Virtually all the basic laws of physics employed 
in nursing are discussed. 240 Pages 139 lIlustrations 
1960 Paperbound $3.75. 
BASIC MICROBIOLOGY 
By Margaret F. Wheeler, R.N., A.M.; and Wesley A. 
V olk, Ph.D. 
A clear and concise introduction to the basic aspects 
of microbiology. Coverage includes: discussions of 
bacteria, protozoa, viruses, rickettsiae and other micro- 
organisms and their relevance to health and disease. 
Pathogens are grouped according to portal of entry, 
in reldtion to body systems. Chapter summaries, ques- 
tions, illustrations and charts contribute to overall 
clarity. 389 Pages 163 lIlustrations 1964 $6.25. 


NUTRITION IN HEALTH AND DISEASE 
By Lenna F. Cooper, Sc.D.; Edith M. Barber, M.S.; 
Helen S. Mitchell, Ph.D., Sc.D.; and Henderika J. Ryn- 
bergen, M.S.; with the assistance of Jessie C. Greene, 
B.S. 
Because of vigorous streamlining, this book has gained 
in versatility both as a text for basic nutrition courses 
and for diet therapy. The 14th Edition includes up-to- 
date tables, bibliography, and an expanded glossary. 
615 Pages 101 lIlustrations 14th Edition, 1963 $7.50. 


Clinical Nursing 
SCIENTIFIC FOUNDATIONS OF NURSING 
(Formerly Science Principles Applied to 
Nursing) 
By Madelyn T. Nordmark, R.N., M.S.; Anne W. Roh- 
weder, R.N., M.N. 
To bridge the gap between scientific theory and clinical 
practice. This book should be in every student's hands. 
It is an indispensable tool for problem solving, nursing 
diagnosis, intervention, and review. About 250 Pages 
2nd Edition, 1967 Paperbound, about $5.00 Cloth- 
bound, about $7.00. 


FUNDAMENTALS OF NURSING: 
The Humanities And The Sciences In 
Nursing 
By Elinor V. Fuerst, R.N., M.A.; and LuVerne Wolff, 
R.N., M.A. 
This text is designed to give the student a sound underi 
standing of the principles underlying all nursing action. 
The problem-solving approach is stressed to enable 
the student to act flexibly and analytically in any given 
situation. Emphasis is on "core" content common to 
every area of nursing practice. 661 Pages 158 lIlustra- 
tions 3rd Edition, 1964 $6.50. 


PROGRAMMED MATHEMATICS OF 
DRUGS AND SOLUTIONS 
By Mabel E. Weaver, R.N., M.S.; and Vera J. Koehler, 
R.N., M.N. 
Shows the student - step by step - how to apply her 
basic knowledge of mathematics to the administration 
of drugs and solutions. The 1966 Printing contains a 
chapter on medications for infants and children. 109 
Pages 1966 Printing Paperbound, $2.25. 


FUNDAMENTALS OF MEDICATIONS: 
Dosages, Solutions and Mathematics 
By Joy B. Plein. Ph.D.; and Elmer M. Plein, Ph.D. 
Uniquely keyed to current nursing practice, this new 
text-workbook for Pharmacology 1 includes: sources 
of drugs, dosage forms, routes of administration, 
mathematics of drug administration, medication orders, 
pediatric dosages and legislation regulating the use of 
drugs. About 125 Pages New, 1967 Paperbound, about 
$3.50. 



Fall Classes 


CARE OF THE ADULT PATIENT: 
Medical-Surgical Nursing 
By Dorothy W. Smith, R.N., Ed.D.; Claudia D. Gips, 
R.N., Ed.D. 
Extensively rewritten, this patient-centered textbook is 
more valuable than ever to the instructor and student. 
Relevant concepts from the life sciences have been 
integrated throughout the text. New nursing principles 
and practices created by medical progress have been 
included. 1206 Pages 406 Illustrations 2nd Edition, 
1966 $11.25. 
TEXTBOOK OF MEDICAL-SURGICAL 
NURSING 
By Lillian Sholtis Brunner, R.N., M.S.; Charles Phillips 
Emerson, Jr., M.D.; L. Kraeer Ferguson, M.D., 
F.A.C.S.; and Doris Smith Suddarth, R.N., M.S.N. 
This comprehensive textbook of nursing care provides 
a wealth of information and an intelligent understand- 
ing of every patient regarding altered physiology, signs 
and symptoms, management of his condition and 
problems, appreciation of emotional state and rehabili- 
tation. 1198 Pages 509 Illustrations, 48 in color 1964 
$12.50. 
PATIENT STUDIES IN MEDICAL- 
SURGICAL NURSING 
By Jane Secor, R.N., M.A. 
Twenty-six patient studies focus on patients as persons 
who have major medical or surgical problems, and who 
require creative nursing care. The author skillfully 
interweaves ethics, the hospital milieu, legal implica- 
tions, interpersonal relationships, psychosocial aspects, 
and the family. About 400 Pages New, 1967 Paper- 
bound, about $5.25. 


BASIC PSYCHIATRIC CONCEPTS 
IN NURSING 


By Charles K. Hof/ing, M.D.; Madeleine M. Leininger, 
M.S.N., Ph.D.; and Elizabeth A. Bregg, R.N., B.S. 
Advances in psychiatry with implications for increased 
nursing responsibilities are reflected in this new edition. 
Problem-solving, process recording and short and 
long-term nursing goals are stressed. Nurse-patient in- 
teraction is clarified by patient studies. Helpful sum- 
maries follow each chapter. About 575 Pages 2nd Edi- 
tion, 1967 About $7.00. 


PATIENT STUDIES IN MATERNAL 
AND CHILD NURSING: 
A Family-Centered Student Guide 
By Ann L. Clark, R.N., M.A.; Hella M. Hakerem, 
R.N., M.A.; Stephanie C. Basara, R.N., M.A.; and 
Diane A. Walano, R.N., M.A. 
Designed for integrated maternal-child nursing courses, 
this book also correlates effectively where obstetrics 
and pediatrics are taught separately. Realistic patient 
situations enable the student to identify the nursing 
needs of mothers and children and to plan nursing 
action based on her knowledge of the sciences. 305 
Pages 1966 Paperbound, $5.00 Clothbound, $7.25. 


MATERNITY NURSING 
By Elise Fitzpatrick, R.N., M.A.; Nicholson J. East- 
man, M.D.; and Sharon Reeder, R.N., M.S. 
Family-centered throughout, the II th Edition has been 
brought completely up-to-date. "This is the book for 
which we have been waiting," writes one instructor, 
"it is readable, the illustrations are excellent, and the 
family-centered approach is of infinite value." 638 
Pages 311 Illustrations I I th Edition, 1966 $8.00. 


ESSENTIALS OF PEDIATRIC NURSING 
By Florence G. Blake, R.N., M.A.; and F. Howell 
Wright, M.D. 
Offers the student a rich source of material on all 
phases of the nursing of children, i.e., how to recog- 
nize, understand, appreciate and meet the emotional, 
physical and social needs of the child. Presented ac- 
cording to age levels from birth to adolescence. 815 
Pages 237 Illustrations 7th Edition, 1963 $8.00. 


FOUNDATIONS OF PEDIATRIC NURSING 
By Violet Broadribb, R.N., M.S. 
A "shorter" presentation, confined to the cardinal prin- 
ciples involved in the nursing of children. In this new 
text the author provides commonsense guidance and 
specific suggestions for nursing action. Content is struc- 
tured according to age groups. About 600 Pages 1967 
Paperbound, about $5.00 Clothbound, about $7.50. 


For Senior Seminars 
SOCIAL INTERACTION AND 
PATIENT CARE 
Edited by James K. Skipper, Jr., Ph.D.; and Robert C. 
Leonard, Ph.D. 
This well-researched book of readings serves as a link 
between the social sciences and clinical practice. Its 
35 articles, accompanied by editorial commentary, deal 
with the nurse's role, communication, the patient's 
view, structural and cultural environment, and role 
conflicts. 400 Pages 1965 Paperbound $4.75. 


PROFESSIONAL NURSING 
Foundations, Perspectives and 
Relationships 
By Eugenia K. Spalding, R.N., M.A., D.H.L.; and 
Lucille E. Notter, R.N., Ed.D. 
This text presents the student with the essential final 
step in the process of evolving into an independently 
thinking and acting professional person, with a broad 
view of the traditions, trends, opportunities and chal- 
lenges of nursing. 684 Pages 75 Illustrations 7th Edi- 
tion, 1965 $8.50. 


-:::LiPPincot
 
60 FRONT STREET WEST, TORONTO 1, ONTARIO 



Katherine E. MacLaggan 


A Tribute 


Katherine E. MacLaggan, president of the Canadian Nurses' Association, 
and director of the School of Nursing, University of New Brunswick, died 
February 6, 1967, in Saint John, New Brunswick. 
Her death brings to an end a career that provided outstanding leadership in 
Canadian nursing. 
Dr. MacLaggan was born in Fredericton, N.H., and received her early 
education and preparation as a teaoher in that city. Becoming interested in 
nursing, she entered the School of Nursing of the Royal Victoria Hospital. 
Montreal, and graduated in 1943. Following this, she enrolled in the McGill 
School for Graduate Nurses and obtained a diploma in public health nursing in 
1945. Two years later she returned to the same institution to complete require- 
ments for the degree of baohelor of nursing. 
In 1957 she obtained a master of arts degree from Teachers College, 
Columbia University, and in 1965, a doctor of education degree from the same 
university. 
Dr. MacLaggan's professional experience includes staff positions at the 
Royal Victoria Hospital, in industry, and in the public health nursing service 
of the New Brunswick Department of Health. Prior to her appointment as the 
first director of the University of New Brunswick Sohool of Nursing in 1958, 
she was assistant director of public health nursing in the province and a faculty 
member of Teachers' College, Fredericton. 
Some nurses will remember Katherine MacLaggan as a capable, humanistic 
practitioner of nursing. Others will remember her as a superb teacher, an able 
administrator, an understanding counselor, and a gentlewoman of great integrity, 
courage, and strength of purpose. 
Many nurses of today and of future generations will remember Katherine 
MacLaggan for her perceptive observations and sound recommendations 
concerning nursing education. Her brilliant dissertation Portrait of Nursing: 
A Plan for the Education of Nurses in the Province of New Brunswick, in 
which she lucidly and forcefully set forth her philosophy of nursing and nursing 
education, has already provided a goal for educators in her native province. It 
is being examined with interest by educators in other provinces. 
Those who knew Katherine MacLaggan well, will remember her as a person 
first, and as a nurse second. She gave much of herself to many. She was never 
too busy to listen to a colleague's problems over a cup of coffee, or to take a 
visitor on a guided tour of her home city, Fredericton, of which she was so 
proud. 
In her Acceptance Address as newly-elected President of the Canadian 
Nurses' Association last July, Dr. MacLaggan stated: "You have a right [as 
CNA members] to demand that your president has integrity, will offer a leader- 
ship subject to guidance, and will make decisions and bear the consequences...." 
This integrity she had. This leadership she gave. 
The President continued: "Our conflict no longer concerns the problems 
themselves; it concerns the status quo versus change. It is a delusion to think 
that change can be avoided... The luxury of delay has disappeared. I ask you 
to provide, on every occasion, what is necessary to the implementation of an 
idea whose time has come. 
"If decisions, or policies, or laws, or persons prove to be inadequate to the 
ongoing scheme of things, remember that these are not forever and can be 
changed at the next time of decision taking. What remain forever are: intellectual 
honesty, values, courage, action and results." 
This was her philosophy. 


26 THE CANADIAN NURSE 


MARCH 1967 



\ 


. 


. . 


MARCH 1967 


THE CANADIAN NURSE 27 



Telegrams Expressed Grief... 


Immediately following the untimely death of Katherine E. MacLagsan, 
President of the Canadian Nurses' Association, many expressions of sympathy 
were received at National Office. 


From individuals 
"Our sympathy and prayers go out to you. .. at this 
sad time. Katherine's great contribution to nursing in 
Canada will remain always a tribute to her name. - 
Penny Stiver." (Former Executive Director, Canadian 
Nurses' Association.) 
". . . I share your sorrow. At the same time, I asso- 
ciate myself with wider groups in nursing nationally and 
internationally, in grateful tribute to Katherine E. Mac- 
Laggan's magnificent contribution in leadership, vision, 
and courage. - Dorothy Percy, Ottawa." (Former Chief 
Nursing Consultant, Department of National Health and 
Welfare.) 
"To the nurses of Canada, deepest sympathy on the 
great loss in death of your President. - Lucy D. Ger- 
main, Assistant Director, Pennsylvania Hospital, Phila- 
delphia." (Former Executive Director of the American 
Journal of Nursing Company.) 
From hospital and university staff 
"On behalf of all nursing staff... we convey... our 
profound regret at the loss of Dr. Katherine E. Mac- 
Laggan, our National President. We were keenly aware of 
and proud of her professional stature. For those now 
entrusted with providing continuity for the task to which 
she brought such distinction, we offer our deepest sym- 
pathy and support. - Helen D. Penney, Director of 
Nursing, Central Newfoundland Hospital, Grand Falls, 
Nfld." 


"Sincere condolences on the death of Dr. Katherine E. 
MacLaggan, CNA President. Miss R. Cunningham, 
Director, School of Nursing, St. Paul's Hospital, Van- 
couver, B. C." 


"Please accept our sincere condolences on the death 
of our Association President, Dr. Katherine E. MacLag- 
gan. - Faculty, Misericordia School of Nursing, Win- 
nipeg, Manitoba." 
"The Faculty and Students. . . extend. . . to the Can- 
adian Nurses' Association their sincere sympathy in the 
loss of one who has contributed so much to nursing. - 
Lillian Brady, Director of Nursing Education. Halifax 
Infirmary School of Nursing, Halifax, N.S." 
"Personnally and on behalf of the nursing staff of 
the University of Alberta Hospital, I extend sincere 
sympathy. - M. Geneva Purcell, Director of Nursing. 
University of Alberta Hospita1." 
"The board and staff... express their sympathy to 
the Canadian Nurses' Association in the death of their 
president, Dr. Katherine E. MacLaggan. - Director of 
Nursing. Moose Jaw Union Hospital, Moose Jaw, Sask." 
"Very sensitive to your loss. Sympathy and prayers. 
- Sister Françoise Robert and Faculty, School of Nurs- 
ing, University of Ottawa." 
From government personnel 
"We join the nurses of this and other countries in 
28 THE CANADIAN NURSE 


paying tribute to Katherine MacLaggan. We join her 
friends and family in gratitude for her life and in sorrow 
for her death. Our sincere sympathies. - Senior Nursing 
Officers of the Department of National Health and 
Welfare." 


"The Deputy Minister and Officials of the Department 
of Health join me in extending to you. .. sincere con- 
dolences on your great loss. - Stephen H. Weyman, 
M.D., Minister of Health, Province of New Brunswick." 
"Most sincere regrets from administrative and nursing 
staff on death of Dr. Katherine E. MacLaggan. Her 
efforts in the field of nursing will exert a lasting influence 
in Canada and internationally. - O.H. Curtis, M.D., 
C.M., D.P.H., Deputy Minister of Health, Province of 
Prince Edward Island." 


From associations 
"Sincere condolences. .. Katherine MacLaggan was a 
great lady and a distinguished leader in Canadian nurs- 
ing. - President and Members, Association of Nurses 
of the Province of Quebec." 
"Our heartfelt sympathy on the death of Dr. Kathe- 
rine E. MacLaggan. - Nurses of the Labrador City 
Wabush Chapter, Labrador." 
"Deeply regret to learn of the death of your Presi- 
dent. Dr. Katherine MacLaggan was a most dedicated 
educator and leader. Her presence will be surely missed. 
- Chaiker Abbis, President, Canadian Hospital As- 
sociation." 


"Regret untimely passing of Katherine E. MacLaggan 
who made unique contribution to nursing education and 
the national organization. - M.T. MacFarland, M.D., Re- 
gistrar, College of Physicians and Surgeons, Winnipeg, 
Manitoba. " 
"The deepest regrets of our Association on the death 
of your President. - W.C. Sinnott, Secretary, Hospital 
Association of Prince Edward Island." 
"The ANA grieves with you over the untimely death 
of Katherine E. MacLaggan, well known to us for her 
forward-looking and progressive leadership in nursing. 
We extend our deepest sympathy with the sad realiza- 
tion that your loss is our loss too. - Judith G. Whitaker, 
Executive Director, American Nurses Association, New 
York. " 
"Deepest sympathy to the Canadian Nurses' Associa- 
tion and to all Canadian nurses on the death of Presi- 
dent Katherine E. MacLaggan. Am notifying ICN mem- 
ber associations. - Sheila Quinn, Deputy Executive 
Director, International Council of Nurses, Geneva, Swit- 
zerland. " 


"The members of the Association of Nurses of Prince 
Edward Island share with you at CNA Headquarters 
a great personal loss in the early death of our President, 
Dr. Katherine E. MacLaggan. - Helen L. Bolger, 
Executive Secretary Registrar, ANPEI." 


MARCH 1967 



The disparity in health standards bet- 
ween the Arctic and southern Canada 
has prompted a committee of the Cana- 
dian Pediatric Society to study the 
Eskimo health problems, and to make 
suggestions as to how pediatricians can 
cooperate with and support the pro- 
grams presently being carried out by 
the Northern Health Services of the 
Department of Health and Welfare. As 
a result, in July of 1965, The Montreal 
Children's Hospital started to send a 
senior pediatric resident each month 
to serve in the new 28-bed hospital at 
Frobisher Bay, Baffin Island. 
A harsh land 
The health problems of the arctic 
must be considered in relation to th\': 
geography, climate, and the history of 
its people. The 1,253,000 square miles 
of land comprising the Northwest Terri- 
tories equal the combined area of the 
Atlantic Provinces, Quebec, Ontario, 
and Manitoba. Distance alone creates 
a problem in survival. In the Eastern 
Arctic (Baffin and Ellesmere Islands) 
Precambrian rocks form mountains, 
often divided by glaciers, which rise to 
10,000 feet and fall in spectacular 
cliffs into majestic fjords. The vegeta- 
tion consists only of lichens, mosses 
and a few shrubs. 
In this land, the dog sled or skidoo 
is useful only on the coastal areas 
during the winter. Effective transporta- 
tion of men and materials depends on 
the airplane in winter, and on coastal 
vessels during the short summer. 
MARCH 1967 


Medical care of 
Eskimo children 


Small northern hospitals now have something new - a pediatric resident. 


N. Steinmetz, M.D. 


During break-up and freeze-up most 
transportation comes to a standstill, 
although some of the larger settlements 
have landing strips on firm soil. Radio 
is still the chief means of communica- 
tion. 
The climate makes severe demands 
on housing and clothing. Great skill is 
required to live off the land. Between 
November and February it is genuinely 
cold, the temperature falling to minus 
30-40 degrees F, and only in June, 
July and August does the average tem- 
perature rise to 40-45 degrees F. Strong 
winds and blowing snow are the chief 
hazards in overland travel. 


A hard life 
Traditionally, all the Eskimos lived 
along the coast in family units, and 
moved to follow the game upon which 
their survival depended. Starting as 
early as 1000 A.D., but mainly between 
the sixteenth and eighteenth centuries, 
they had increasing contact with white 
explorers. During the 1800's they dealt 
with whalers, fur traders, and mission- 
aries. Gradually they settled near 
trading posts as the latter developed, 
and sought employment there. The 
white man established these settlements 
according to criteria that satisfied his 
own requirements. 
The town of Frobisher Bay, for ex- 
ample, was never an Eskimo settle- 


Dr. Steinmetz is pediatric resident at The 
Montreal Children's Hospital, and particip- 
ated in the program at Frobisher Bay. 


ment. In 1914 the Hudson Bay Com- 
pany established a trading post else- 
where on the Bay. In 1942, the United 
States built a military airfield in Fro- 
bisher, obviously because it was a good 
place to have an airfield, not because 
the area was a good hunting ground. 
Of the approximately 3,000 Eskimos in 
the Eastern Arctic, nearly one-half of 
them now live in Frobisher Bay, which 
is for them an artificial location. Here, 
as in other such settlements, the men 
find little opportunity to use their 
special skills for hunting and arctic 
survival. Consequently these skills are 
as foreign to the new generation as 
they are to us. The Royal Canadian 
Mounted Police now teach Eskimo 
Boy Scouts how to make igloos. 
Education, as we know it, is now 
being provided to children, but the 
percentage of the population over 15 
years of age without schooling is re- 
markably high - 34 percent in the 
North West Territories compared with 
1.4 percent in the rest of Canada.! The 
birth rate is more than twice that of 
the rest of Canada; the under-four- 
years age-group comprises the largest 
group of the Eskimo population in the 
Eastern Arctic. Hence the interest of 
Canadian pediatricians in improving 
the medical care of these people. 


Pediatric care essential 
The economic situation is such that 
a bare, prefabricated, one-room dwel- 
ling (4 walls, 1 roof, 2 windows) costs 
$1000, a gallon of fuel oil costs 60ç, a 
THE CANADIAN NURSE 29 




 



 



 



 


30 THE CANADIAN NURSE 


--....... 


# 


J 


, 
. 


'- 


gallon of water 1
. The per capita 
income of the northern Eskimo is $426 
per year compared to $1,734 for the 
rest of Canada.:! Under these conditions 
it is difficult to build an environment 
conducive to good health. Diseases that 
could be prevented by education, im- 
proved living standards, and accessibili- 
ty of treatment still take a huge toll in 
life. 
The task of providing effective me- 
dical care to this scattered population 
is presently being attempted by the 28- 
bed Frobisher Bay Hospital under three 
doctors, by the 28-bed missionary 
hospital in Pangnirtung, which is staffed 
by three very able nurses, by several 
nursing stations, and by lay dispensers 
in small outposts. 
The infant death rate per 1000 live 
births is 6
 times that for the rest of 
Canada, and the death rate for children 
one to four years of age is 15 times 
that for the rest of Canada. 3 


Death Rates for Infants Under I Year 
of Age - Per 100,000 Live Births. 4 
NWT P.Q. Canada 
Lower Respiratory 
Tract Infection 5458 473 434 
Gastroenteritis 1463 153 120 


--'- 


The death rate of female children 
is significantly greater than that for 
males. 
Three out of five children are born 
at home, delivered by women who have 
learned the art from their ancestors. 
Pre-and postnatal care, as we know it, 
is difficult to provide for such a far- 
flung population. 


Simple diseases have serious effects 
Among the greatest causes of death 
in infants under one year of age are 
lower respiratory tract infections and 
gastroenteritis, each 12
 and 12 times 
as common as in the rest of Canada. II 
These figures all look very dramatic, 
but it must be remembered that they 
have to be interpreted with care, due 
to the small number of the population. 
The Eskimos living on the trading 
post no longer have easy access to 
their native diet, and cannot afford nor 
know how to choose a balanced diet 
MARCH 1967 



from the variety of foods available in 
the white man's stores. All too often 
potato chips and soft drinks form a dis- 
proportionate amount of their pur- 
chase. As a result malnutrition is mani- 
fested by the appearance of vitamin D 
deficiency, rickets, and iron deficiency 
anemia. These diseases are not seen in 
the more remote camps where raw 
meat is the staple diet- 
Impetigo, upper respiratory tract in- 
fections, and draining ears are common- 
place. Our experience suggests that in 
the Eastern Arctic there is a relation- 
ship between middle ear disease and 
social conditions. as was demonstrated 
by Cambon et al 6 in the Western 
Arctic. 
Several epidemics of viral disease 
have been recorded. 7 They have been 
more severe in remote areas than in 
more concentrated populations where 
immunological resistance is higher. 
With this in mind, a widespread pro- 
gram of measles vaccination has re- 
cently been undertaken by the Northern 
Health Service. 
Memophilus influenza and meningo- 
coccal meningitis have been reported 
to occur more frequently than in the 
rest of Canada. In Frobisher Bay we 
have seen five to seven cases per month 
whereas the average from a much larger 
population at The Montreal Children's 
Hospital is 4.4 cases per month. Poor 
housing. inadequate nutrition in settle- 
ments, and resulting decreased resistan- 
ce are likely contributory causes. 


Chronic disease is common 
The increasing influx of transient 
laborers has been associated with a 
rising incidence of venereal disease in 
adolescents. 
Routine chest roentgenograms of 
Eskimo children referred to The Mon- 
treal Children's Hospital for various 
reasons have frequently demonstrated 
a diffuse chronic non-tuberculous lung 
disease. Clinically, the child mayor may 
not cough, and sometimes no adventi- 
tious sounds are heard on auscultation. 
The significance of these findings is 
not known, nor is the cause or course. 
Tuberculosis has been a problem in 
the Eskimo population only since the 
MARCH 1967 


second half of the 1800's, when con- 
tact with whalers, trappers, and traders 
became established. As late as 1955-57 
Schaefer 8 estimated that 5- 1 0 percent 
of all Eskimos reached by the Eastern 
Arctic Patrol had to be evacuated for 
treatment of active tuberculosis. A vi- 
gorous program of BCG vaccination. 
case finding, and treatment is reducing 
this problem. 


A. new frontier 
The government departments dealing 
with Canada's northland have made 
great strides in recent years in improv- 
ing living and health standards of the 
Eskimo, and in providing education 
and training. However, much remains 
to be done. In the same spirit in which 
other Canadian university centers have 
initiated medical services in the North, * 
so The Montreal Children's Hospital is 
sending its residents to Frobisher Bay. 
Here they are responsible for those 
children requiring special medical care, 
and as a result are often able to reduce 
evacuations for treatment. 
The residents run two well-baby 
clinics a week, and work in the out- 
patients department every afternoon. 
An important aspect of their work is 
the provision of follow-up care to those 
children who have returned from The 
Montreal Children's Hospital after 
having been treated there. Thus, com- 
munication between the two hospitals 
has improved greatly. We hope that by 
complementing the work of the North- 
ern Health Service, their presence will 
improve the medical care of Eskimo 
children. 
The project has already proven its 
worth as a training experience by de- 
monstrating how much can be achieved 
far away from a sophisticated medical 
center. Residents are more intimately 
involved with the family and the child's 
home. Much interest in the medical 
problems of the Arctic is already being 


*Queen's University, Kingston, Ont., sends 
interns to Moose Factory in Northern On- 
tario, and the University of Alberta pro- 
vides intern service for the Inuvik area at 
the mouth of the Mackenzie River in the 
Northwest Territories. 


stimulated as a result of this contact. 
In summary, we "Southerners" have 
been responsible for disturbing the 
ecology of the Arctic. We have tempted 
the Eskimo with our way of life, and 
made him dependent on our technolo- 
gy. As these programs of medical 
service mature, we hope they will help 
to restore the new generation to better 
health. This done, the Eskimo will be 
able to benefit from the training and 
education that can equip him to parti- 
cipate in our civilization. 
References 
l. The Northwest Territories Today. A re- 
ference paper for the Advisory commis- 
sion on the Development of Govern- 
ment in the Northwest Territories. Ot- 
tawa, Queen's Printer, 1965, p. 18. 
2. Ibid., p. 123. 
3. Ibid., p. 19. 
4. Dominion Bureau of Statistics. Vital 
Statistics 84-202 (1960) Ottawa, Queen's 
Printer, 1962. 
5. Ibid. 
6. Cambon, K., Galbraith, J.D., and Kong, 
G. Middle Ear Disease in Indians of 
the Mount Currie Reservation, British 
Columbia. CMAJ, 93: 1301, 1965. 
7. Schaeffer, Otto, Medical Observations 
and Problems in the Canadian Arctic. 
CMAJ. 81: 248, 1959. 
8. Ibid. 0 


THE CANADIAN NURSE 31 



Nursing in 
the North 


Nuning on Conodo's modern-doy 
frontier offen 0 wide voriety 
of experience ond numerous 
opportunities. Nunes ore essentiol 
in bringing 0 heolth program 
to the vast northern area of 
Canada where geography is the 
single greatest enemy of health. 


32 THE CANADIAN NURSE 


Health care to the more than 200,000 
residents scattered over 3,500,000 square 
miles of territory is provided by the 
Medical Services Branch of the Department 
of National Health and Welfare. 


Over 800 nurses, working in hospitals or 
from nursing stations and health centers 
located in trading posts and settlements, 
meet the challenge of providing 
comprehensive, community-type health 
programs - even such programs 
as managing your first two-wheeler. 


, 


, 
'\ 
\ 
,\ 



 

' 


The northern nurse's responsibilities include 
communicable disease control; 
immunization programs; health supervision 
and teaching through home visits, 
child-health, pre- and postnatal clinics; 
and health consultant in home, 
school and community. 


This 28-bed hospital at Frobisher Bay 
is one of 16 hospitals maintained 
by the Medical Services Branch. 


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MARCH 1967 




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The hospitals conform to federal standards 
and are built in accord with the north's 
special needs. They are well-equipped and 
are far from primitive. 


Outpost nursing stations, 42 of them, ure 
located in isolated areas that hal'e no 
resident physician. Two nurses, one well- 
qualified in obstetrical nursing, and one 
with public health preparation, staff 
these centers for emergency care and 
n'acuation of the seriously ill. 


':!' 


Visiting nurses work mainly from health 
clinics in semi-isolated centers. The nurse 
in the north tral'els by any means al'ailable: 
plane, canoe, dog-team, fishing boat, 
and, where there are roads, car. 


School health IS one aspect of the total 
community program. The nurse and teacher 
work together to strengthen home and 
school health. 


=-=- " I '!
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Winter working dress for the public health 
nurses includes a nath'e parka and ski 
outfit. A new uniform is being made up 
and will include a dress suit, topcoat, 
slack outfit, and ski suit. D 


MARCH 1967 


THE CANADIAN NURSE 33 



During the last half-dozen years, the 
School of Nursing and the Medical 
School at Dalhousie University have 
become aware that nurses serving in 
the remote, sparsely populated areas 
of Canada's Northland are required to 
provide ca:e far beyond the horizons 
defined by nursing education in Cana- 
da. Dr. Robert C. Dickson, Professor 
of Medicine at Dalhousie University 
Medical School, and others have had 
opportunity for travel and observation 
in the Canadian North, and a liaison 
has developed between the University 
and one organization providing north- 
ern health services. 
Everywhere in the North the provi- 
sion of health services tends to follow 
one general pattern. Regional hospitals, 
preferably with several doctors, are 
surrounded by satellite nursing stations 
staffed by one or more nurses. Trans- 
portation, usually by air, is provided 
from the satellite nursing station to the 
regional hospital when weather condi- 
tions permit, and some sort of radio 
communication is maintained between 
them. 
The nursing stations vary in size and 
facilities offered, but they serve as a 
center for the health program through- 
out the surrounding district, providing 
outpatient clinics at the nursing station, 
a few beds for inpatients, and a public 
health program. A midwifery service is 
provided, and there are beds and 
bassinets in the station for obstetrical 
patients. Initial care for seriously ill 
patients awaiting transport to the re- 
34 THE CANADIAN NURSE 


Outpost nursing 


A new program at Dalhousie University helps prepare nurses for positions in 
remote areas of the North. 


Ruth E. May, B.A., R.N., CM. 


gional hospital is given in the station, if 
possible under the radio direction of a 
doctor at the nearest hospital. 


A lack of doctors 
It is obvious that a nurse at a 
northern nursing station will be pro- 
viding services which fall within the 
prerogative of a doctor in other parts 
of Canada. Although a doctor may 
visit from time to time and be available 
for some radio consultation, many of 
the nurse's day-by-day activities will 
require judgment and skill beyond the 
scope of what we normally consider 
to be nursing. 
It is impossible to provide doctors 
now at this level; there are simply not 
enough available. Moreover, a familiar- 


Miss May is the newly appointed Lecturer 
in Outpost Nursing at the Dalhousie Uni- 
versity School of Nursing. She holds a B.A. 
degree from Wellesley College, Wellesley. 
Mass., and is a graduate of the Massachu- 
setts General Hospital School of Nursing 
in Boston. She received her midwifery 
preparation at the Frontier Nursing Service 
Graduate School of Midwifery in Kentucky, 
and has served for a number of years with 
the International Grenfell Association in 
northern Newfoundland and Labrador. For 
the past eight years she has been nurse- 
in-charge of the nursing station and sur- 
rounding district at Mary's Harbour, Labra- 
dor, an area in which about 1500 Labra- 
dor fishermen live. Miss May has also been 
a member of Nurses' Christian Fellowship. 


ity with this type of service leads one 
to feel that doctors should not be used 
at this grass roots level even if they 
were available. The total population 
served by one of these stations is small 
and often widely scattered. There is 
little to attract a doctor professionally. 
Diagnostic facilities are of necessity 
very limited in a station of this size. 
Any surgery requiring general anesthe- 
sia, no matter how minor, is usually 
not possible as there is normally no one 
qualified to give anesthesia safely. A 
very large number of the doctor's pa- 
tients would need to be referred to the 
regional hospital, often not because the 
doctor lacked the medical background 
to care for them, but because the re- 
quisite facilities would be lacking. 
[s it reasonable, one asks, for a per- 
son educated amid all the intricacies of 
latter twentieth century medicine to 
work where it is impossible for him to 
use a considerable portion of the know- 
ledge he has acquired and where 
further professional growth is neal1Y 
impossible? How much better for him 
to serve as a member of a medical 
team at a regional hospital and for 
specially prepared nurses to continue 
to serve at the nursing station level. 
As a familiarity with northern facil- 
ities developed, one fact became in- 
escapable. A large number of the 
nurses serving in northern nursing sta- 
tions are either foreign born or foreign 
educated. This pattern developed es- 
sentially because it was desirable for 
these nurses to have formal preparation 
MARCH 1967 



in midwifery, and such preparation is 
difficult to obtain on this side of the 
Atlantic. Gradually a conviction arose 
that facilities should be provided in 
Canada to help Canadian girls wishing 
to work in remote areas of the North. 
We hear much these days about the 
responsibility of the highly developed 
nations to the developing areas of the 
world and the personal rewards of this 
"Peace Corps" type of service. Why 
not a plan to prepare Canadian nurses 
for service in the isolated areas of the 
Canadian North, a plan which would 
include preparation not only in mid- 
wifery but in all the areas where the 
nurse is required to function beyond 
the scope of nursing elsewhere in 
Canada. 


A new program is born 
Thus the Outpost Nursing Program 
at Dalhousie was born. The entire fac- 
ulty of the School of Nursing and 
key persons at the University Medical 
I School have been most enthusiastic. A 
program extending over two calendar 
years has been planned and will be di- 
rected by a member of the University 
School of Nursing faculty who is a 
qualified midwife with an extensive 
background of northern service at the 
nursing station level. 
The first class, to be admitted in 
September, 1967, will be limited to 
eight students, as the clinical experience 
will be highly individualized with in- 
tensive tutorial type teaching maintain- 
ed in all areas. Applicants must be 
graduate nurses and are asked to have 
completed at least one year of pro- 
fessional nursing experience. Prepara- 
tion in public health nursing, a vital 
area in northern service, will be inte- 
grated throughout the program, and a 
university diploma in public health 
nursing as well as a diploma in outpost 
nursing will be awarded at the comple- 
tion of the program. Within the next 
year or two a shortened course for 
students who already have preparation 
in public health nursing will be devised. 
Students will spend their first year 
in Halifax. Lectures and seminars in 
basic public health nursing will be 
provided during this year and also 
clinical teaching within the areas of 
general medicine, surgery, pediatrics, 
and midwifery. Some lectures in ma- 
teria medica and some basic laboratory 
experience will be included. Three 
teaching hospitals in Halifax have of- 
fered clinical resources most enthu- 
siastically for the students, and 
clinical teaching and experience will 
be carried out there, primarily at 
the bedside, under the direction of 
medical school personnel working in 
cooperation with the lecturer in outpost 
nursing. Opportunity will be given for 
MARCH 1967 


the student to develop some skill in 
basic physical examination and also in 
various specific procedures such as the 
starting of intravenous infusions, su- 
turing, and the opening of superficial 
abscesses. 
The second year will consist of an 
internship under the direction of the 
University in a northern setting, using 
selected hospitals and nursing stations 
of the International Grenfell Associa- 
tion and the Department of National 
Health and Welfare. The students will 
spend half of this year exclusively 
within the area of midwifery at St. 
Anthony Hospital, St. Anthony, New- 
foundland. The remainder of the year 
will provide further teaching and su- 
pervised experience in public health 
nursing and in clinical medicine, sur- 
gery, and pediatrics. Opportunity will 
also be given for the students to de- 
velop some skill in routine dental 
extractions. 


Midwifery emphasized 
Particular care has been given to the 
development of the midwifery section 
of the program. A comprehensive nine- 
month experience has been arranged 
with three months during the first year 
in Halifax and the remainder during 
the internship year. Lectures will be 
given by the lecturer in outpost nursing 
and the obstetrical staffs of the hospi- 
tals involved. 
Each student will have the opportu- 
nity to care for in labor, and to deliver, 
approximately 30 to 40 women. Op- 
portunity to evaluate, follow, and con- 
tribute to the care of patients with 
abnormal courses will be provided. 
There will be extensive experience in 
antenatal clinics with emphasis on 
patient and family teaching. During the 
internship, when travel permits, there 
will be a program of weekly home 
visits to mothers and babies following 
discharge from hospital. 
Experience in postpartum care and 
management of the normal newborn 
and premature infant will be provided. 
As in all the clinical areas, teaching 
and supervision will be individualized 
on a tutorial pattern. 
This experience will use as a found- 
ation the three months in obstetrical 
nursing that students receive in their 
basic nursing education program. Al- 
though basic obstetrical nursing is not 
midwifery, it does serve as a very useful 
background, and some lectures review- 
ing and expanding this material will be 
given before the students embark on 
their full-time midwifery experience. 
At the end of the program, there- 
fore, the students will have completed 
a total of one year within the overall 
area, three months during the basic 
nursing course, and nine months during 


the outpost nursing program. This has 
been arranged to be equivalent not 
only in time but also in content with 
the British pattern of midwifery pre- 
paration, and the University feels that 
graduates of the program can be ex- 
pected to function at the same level of 
competence. It is hoped that the esta- 
blishment of this experience will re- 
present a significant achievement in the 
history of nursing education in Canada. 
Constant emphasis throughout the 
entire program will be given to the 
early recognition and evalution of sig- 
nificant illness and potential threats 
to the well-being of the patient and his 
family. The nurse must learn to initiate 
treatment or transfer the patient to a 
hospital before an emergency situation 
develops; one of her aims must be to 
prevent the development of emergency 
situations in isolated nursing stations 
whenever this is possible. However, 
there will be discussions of reasonable 
plans of action in unavoidable or un- 
predicted emergencies when medical 
aid or transport to hospital is not im- 
mediately available. 
Considerable thought has been given 
to the identification of those functions 
and procedures that can be taught 
safely to nurses and to those that she 
should avoid. h is essential that the 
students be taught to recognize and 
respect their limitations. It should be 
noted, also, that it is never intended 
for these students to use the specific 
skills developed within this program in 
other areas of Canada where such care 
is provided by resident doctors. 
Arduous, but rewarding 
The type of northern service for 
which this program in outpost nursing 
seeks to prepare nurses is arduous, and 
nurses considering service of this sort 
should face the demands realistically. 
There are likely to be emergency 
situations and tragedies that must 
sometimes be met and accepted alone. 
Many of the common amenities of 
twentieth century living will be lacking. 
There can be periods of drudgery and 
loneliness; in due time the glamor is 
likely to fade. However, those who 
have steeped themselves in this work 
have found the rewards far outweighing 
the demands. There will always be a 
tremendous challenge and satisfaction 
in attempting to provide the best 
possible service to those whose birth- 
right has included so much less than 
ours. 
Hundreds of years ago Jesus said to 
a group of his friends, 
"In so far as you rendered such 
services to one of the humblest of 
these my brethren, you rendered 
them to myself." - Matthew 25: 
40, (Weymouth). D 
THE CANADIAN NURSE 35 



Drug dependency research - 
expensive luxury or necessary 
commodity? 


Mood-changing drugs and their 
effects on those who ingest them have 
received much attention during the 
past few years. Drugs hold a special 
fascination - they at once attract and 
repel. Purveyors of juicy newspaper 
headlines, spicy television programs, 
lurid tales, are guaranteed a market. 
However, whatever sensational quali- 
ties drugs may have, only serious study 
will enhance our knowledge to the 
point where fact rather than fancy will 
prevail. 
Research, for the most part, is not 
sensational. Unless some spectacular 
scientific breakthrough is achieved, it 
does not merit newspaper headlines. 
It is often forgotten that behind each 
striking discovery are years and years 
of quiet and often frustrating research 
and experimentation. Serendipity is 
indeed rare! 
Fortunately, more and more quali- 
fied researchers are now studying 
mood-changing drugs and their physio- 
logical, pharmacological, psychological 
and sociological effects. To be sure, 
one meets the very people who are part 
of interesting tales told, but the collec- 
tion of factual data is an expensive, 
time-consuming and, at times, very 
tedious process. Nor are research re- 
ports recommended bedtime reading 
unless perhaps for quick sleep induce- 
ment. For research into drug depen- 
dency must embrace such mundane 
matters as prevention, pharmacology, 
epidemiology, treatment, and legisla- 
tion. and must assure a systematic ac- 
36 THE CANADIAN NURSE 


In drug dependency research, the questions are still more 
plentiful than the answers. 


Ingeborg Paulus 


cumulation of general knowledge. It 
therefore has to draw on various dis- 
ciplines to make it less of a riddle to 
those engaged in preventing and fight- 
ing a disease that seems to take on new 
shapes as more and more mood- 
changing drugs become known and 
available for experimentation. 


NAF research program 
The Narcotic Addiction Foundation 
of British Columbia (NAF) was found- 
ed in September, 1955, with the objec- 
tive "to develop a research, treatment, 
rehabilitation and education program." 
Many obstacles prevented the develop- 
ment of all goals simultaneously. Con- 
sequently it was not possible until the 
end of 1964 to start the development 
of a research program. 
Research should include a thorough 
examination of the many-faceted as- 
pects of drug dependency and abuse. 
Lack of financial resources have, to 
date, prevented the NAF from doing 
other than rudimentary medical and 
sociological research. We have been 
engaged in sociological research for 
two years. Some projects are finished, 
some are in progress, and some are in 
the planning stages. The following is 
a short account of research undertaken 
by the NAF. 


Miss Paulus is Research Associate with 
the Narcotic Addiction Foundation of British 
Columbia. Vancouver. B. C. 


Past endeavors 
Information Collection on the NAF 
PatienJ Population 
Any research calls for the accumu- 
lation of a body of data that lends 
itself to manipulation. That is, if data 
are to be meaningfully interpreted they 
must be complete rather than frag- 
mentary; they must be ordered into 
some meaningful categories rather than 
be a haphazard mess; and they must 
be accurate. The collection of this kind 
of data is not always easy. It is further 
complicated when the respondent is 
a patient who quite often comes for 
help only when he is drugged, agitated, 
or in the process of withdrawal; in 
other words, when his reasoning and 
memory frequently are impaired. 
This, then, was a first task: to 
devise a suitable form for collecting 
necessary information during the intake 
process, which would provide up-to- 
date knowledge of our patient popula- 
tion. Data on socioeconomic character- 
istics such as age, sex, marital status, 
education, etc., are now easily checked. 
We can get immediate information on 
our patients' origin, period of addic- 
tion and criminal record, accumulated 
either prior or subsequent to addiction. 
Apart from knowing something about 
the NAF treatment population, this 
kind of information is used to devise 
prevention and treatment methods. 
Treatment Results 
One of the primary functions of the 
staff at the NAF is to treat and reha- 
MARCH 1967 



bilitate its patients. How do we know 
whether or not our methods actually 
produce the desired results? One way 
is to compare two similar groups - 
one following a specific treatment 
program, the other not. After a suitable 
time lapse, the two groups can be 
followed up and the effects of treat- 
ment measured and assessed. The re- 
sults of such a study may be inconclu- 
sive, yet they may give clues to success- 
ful treatment approaches. Unfortun- 
ately, this type of prospective treatment 
assessment study is time-consuming. It 
may be five or six years before suffi- 
cient data are available for drawing 
conclusions that can be generalized 
over a larger population. Moreover, 
ethical considerations may prevent this 
type of research. Is one justified to 
treat some patients and not others? 
What criteria for selection should one 
employ? These are very serious ques- 
tions that the treatment team must 
answer before such a study can be 
started. 
Retrospective follow-up studies are, 
at best, compromises. One has a group 
of patients treated some years ago; to 
find out what has happenned to these 
patients since their treatment is diffi- 
cult, since the necessary controls are 
lacking. If a considerable number of 
patients had improved, one would not 
be justified in attributing this to the 
treatment, for other factors, including 
time, may have been equally important 
in bringing about a change. 
At the NAF we were faced with a 
unique situation. In 1963, Dr. R. Halli- 
day, past clinical director, decided to 
change the drug addiction treatment 
radically from that usually practiced in 
North America, by maintaining selected 
patients on small doses of metha- 
done for anywhere from 4 to 52 + 
week periods. At the same time the 
NAF continued treating a portion of 
its patients by giving them regular, 
12-day withdrawals, in conjunction 
with the standard social work, psy- 
chiatric, and medical treatment given 
to all patients. 
We could compare the two treatment 
populations and assess results, but we 
could not assess the effectiveness of 
either type of treatment. Since one 
treatment was quite different from any 
practiced during the past 40 years, we 
decided to do a retrospective follow-up 
study. As expected, the results of the 
study were inconclusive, but they did 
give an impetus to planning a long- 
range prospective study. Without the 
retrospective study, we might not have 
learned anything. By doing it, we 
gained at least enough knowledge to 
guide us in the future. 
Briefly, the study suggested that 
older patients responded more favor- 
MARCH 1967 


ably to either type of treatment. Age 
seemed to be the most important vari- 
able, influencing change in a positive 
direction. For patients over 50 years 
of age, in particular, the prolonged 
methadone treatment program indi- 
cated promising results.. 
From what we were able to learn, 
we concluded that the NAF is serving 
the community by maintaining all pa- 
tients over 50 years on a narcotic 
drug. It seems that various processes 
(to be investigated shortly) take place 
in addicts' lives that can best be de- 
scribed as "maturing-out of narcotic 
addiction" (a term coined by Dr. Char- 
les Winick, director, program in drug 
dependence and abuse of the American 
Social Health Association). But these 
processes seem to fail for a consider- 
able portion of the addict population. 
This portion seems to be unable to 
function without some chemical help. 
To offset the detrimental aspects of 
the illegal procurement of drugs, a 
maintenance-treatment program seems 
an economical choice. As yet, we do 
not know what kind of treatment is 
indicated for younger addict patients. 
We feel that only new experimental 
approaches will help us further. 


Present research 
Barbiturates 
During the past few years, we have 
noted several changes in drug abuse 
patterns. First, increasingly more 
heroin addicts are using barbiturates, 
either alone or in conjunction with 
their heroin or methadone intake. We 
noted a rapid increase in barbiturate 
consumption especially among women. 
We postulated various hypotheses for 
this change in drug abuse patterns, 
which we were testing on a sample of 
our patients. The major hypothesis that 
the supplementation of heroin with 
barbiturates is mainly an economic 
necessity was confirmed. Furthermore, 
the easy availability of barbiturates also 
contributes to their heavy abuse. 
We know that the abuse of barbitur- 
ates and amphetamines is not limited 
to heroin addicts. Unfortunately, our 
resources do not allow us to undertake 
an investigation into these drug abuses. 
A strong necessity for research into this 
problem exists, but it is fraught with 
difficulties. The result is that very few 
accounts other than "popular press" 
articles are available to bring this 
serious abuse, with its detrimental phy- 
sical and social consequences, to the 


l 

 


.-- 


,. 
I 


. Ingeborg Paulus, "A comparative Study 
of Long-term and Short-term Withdrawal of 
Narcotic Addicts Voluntarily Seeking Com- 
prehensive Treatment," Vancouver, B. C.. 
The Narcotic Addiction Foundation of 
British Columbia, April, 1966. 


THE CANADIAN NURSE 37 




 



 
" 


.. 


, 



\ 


\ 


\ 


attention of an uninformed public. 
Psychetklics 
At the present time, there seems to 
be an insatiable demand for accounts of 
the dangers and delights associated 
with the marijuana (cannabis sativa) 
and LSD-25 (lysergic acid diethylamide) 
cult. As expected, the popular press 
has taken the lead in "informing" the 
public about this cult. Speculations and 
half-truths fill page after page. Factual 
research is time-consuming, and before 
responsible findings are released, the 
myths surrounding these drugs seem to 
overshadow the realities. It becomes 
increasingly difficult, even for the wary 
researcher, to separate fact from fancy. 
The NAF study is especially interest- 
ed in distinguishing between the drug 
abuser and the isolated young ex- 
perimenter. It seems to be part of the 
follies, and perhaps the privileges of 
youth, to taste some of the forbidden 
fruits of life. Thus we are trying to 
determine who the young people are 
who are so attracted to psychedelic 
drugs that they risk incarceration and 
a criminal record just to partake of 
these forbidden "pleasures." 
We must ask such questions as: Will, 
in a few years from now, our clinic be 
overrun with narcotic drug users who 
started on their road to addiction via 
the psychedelics? Or will the use of 
psychedelics be a fad with no direct 
consequences as far as our future treat- 
ment population is concerned? Will 
this group of drug abusers need treat- 
ment at all? Or will it need treatment, 
but different from that required by the 
heroin addict? In other words, we are 
trying to find present facts on which 
to base future actions and policies. 


Planned research 
From our past endeavors we are 
perhaps able to answer some questions; 
but our questions are still more plenti- 
ful than our answers. 


Prospective Treatment Follow-up 
Study 
One issue to be investigated, which 
arose out of the retrospective follow- 
up study, is the effectiveness of the 


38 THE CANADIAN NURSE 


present treatment the NAF is able to 
give. The retrospective follow-up study 
could not answer this question, because 
we had no untreated population as a 
control. It did, however, enable us to 
formulate a treatment-research pro- 
gram. The proposed study will be very 
expensive; therefore, its realization is 
dependent on financial support present- 
ly being sought. 
Natural History of Addiction 
A less expensive but no less impor- 
tant project involves the investigation 
of the natural history of addiction. By 
questioning the addict and from ac- 
cumulated records, we want to dis-- 
cover: who the addict was before he 
started to use drugs; the deciding fac- 
tors that made him experiment with 
any kind of drug; the unpleasant re- 
alities he was trying to escape; what 
happened once he started to use drugs; 
the length of the drug-use span; and 
what made him stop using drugs. In 
other words, what does an addict 
career entail? Does it come to a natural 
or unnatural end? And, once ended, 
what then? 


Goal: Prevention of abuse 
When we have answered some of 
these questions, we might be able to 
launch a more effective campaign of 
drug abuse prevention. This, we feel, 
merits our greatest efforts. Although it 
is essential to know how best to treat 
addicts. it is much more essential and 
also less expensive to prevent drug ex- 
perimentation and abuse. The com- 
petition for tax-payers' dollars to 
prevent and cure society's various ills 
is heavy. The more we learn how to 
prevent these ills, the more funds will 
be available to enrich all of our lives. 
It may seem that in view of the pres- 
sing demands for treatment, research is 
an expensive luxury; but viewed in the 
light of its long-term benefits, research 
is one of the most necessary commodi- 
ties when dealing with the riddle of 
drug dependency and abuse. D 


MARCH 1967 



For some years there has been con- 
siderable controversy as to the validity 
- or even morality - of using nar- 
cotic drugs in the treatment and reha- 
bilitation of narcotic drug addicts. To 
many people the concept that addicts 
can be treated or cured appears naïve, 
or even ludicrous; follow-up statistics 
from various treatment centers are 
quoted to indicate that the vast major- 
ity of addicts following treatment, in 
or out of prison, quickly relapse to 
their former way of life, that is, to 
criminal behavior or prostitution, as 
well as to the use of narcotic and other 
addicting drugs. 
On the other hand, there are those 
who commend what they term the 
"British system" of treating addicts. 
They conclude that the relatively small 
number of addicts in Britain (about 
753 according to the British Ministry 
of Health report, 1965)1 is due to this 
supposed method of treating addicts 
there. When compared with Canada's 
known addict population of 3,573 in 
1965,2 (in a population of 20 million 
as compared with Britain's population 
of more than 50 million) it may seem 
that there is something about the legal 
and medical management of addicts in 
Britain that we in Canada might study 
and adopt to our advantage. 


No "system" in Britain 
When one takes a closer look at the 
situation in Britain, a number of facts 
become apparent. First, there is in 
reality no "system" of treating addicts 
MARCH 1967 


Use of narcotics 
addict therapy 


. 
In 


Treatment of persons addicted to narcotics is frequently a dismal failure. The 
question of the role of narcotic drugs in the treatment of such persons 
still remains unanswered. 


Robert Halliday, M.B., D.P.M. 


in Britain if, by system, one means: 
that all addicts are given narcotics 
regularly in the course of treatment; 
that the government has clinics to 
which addicts may go for treatment; 
or that all drug addicts are registered 
and, once registered, are automatically 
placed on a narcotic for an indefinite 
period, or even for life. 
Further, when one considers the law 
relating to the manufacture, sale, dis- 
tribution, and use of narcotics or dan- 
gerous drugs, it becomes apparent that 
British law is very similar to Canadian 
law. 
From whence, then, comes the myth 
of the "British system"? - for myth it 
is. In fact, there is no system of regis- 
tration; nor are there government 
clinics; nor is it government policy (via 
the ministry of health or elsewhere) to 
encourage or direct physicians to treat 
addicts with narcotics. Indeed, in the 
British Ministry of Health report re- 
ferred to earlier, the following recom- 
mendations, among others, are made: 
that all addicts to dangerous drugs be 
reported to a central authority; that to 
treat addicts a number of special treat- 
ment centers should be established, es- 
pecially in the London area; and that 
it should be a statutory offence for doc- 
tors (other than those on the staff of 
the special treatment centers) to pres- 
cribe heroin and cocaine to an addict. 


Dr. Halliday is Co-ordinator of Education 
for the Narcotic Addiction Foundation of 
British Columbia, Vancouver. B.C. 


These recommendations make it quite 
clear that the "British system," so 
lauded by many naïve, if well-meaning 
people, is not a reality. 


Addiction considered an illness 
What does happen in Britain that is 
different from typical Canadian policy 
and practice? As far back as 1924, the 
Rolleston Committee, which investi- 
gated the problem of narcotic drug 
abuse for the British Government, con- 
cluded that morphine or heroin might 
properly be administered to addicts in 
the following circumstances: 
1. Where patients are under treat- 
ment by the gradual withdrawal 
method with a view to cure. 
2. Where it has been demonstrated 
after a prolonged attempt at cure that 
the use of the drug cannot be safely 
discontinued entirely, on account of 
the severity of the withdrawal symp- 
toms produced. 
3. Where it has been clearly de- 
monstrated that the patient, while 
capable of leading a useful and rela- 
tively normal life when a certain mini- 
mum dose is regularly administered, 
becomes incapable of this when the 
drug is entirely discontinued. 
A memorandum from the British 
Ministry of Health to physicians in- 
cluded this statement: "The continued 
supply of drugs to a patient, either 
direct or by prescription, solely for 
the gratification of addiction, is not 
regarded as a medical need."3 
It may be concluded that one sign if- 
THE CANADIAN NURSE 39 



icant difference between the British 
and Canadian attitudes toward addicts 
is that in Britain addicts have been 
recognized as people in need of medical 
help, whereas in Canada and the U.S., 
until recently, the addict has been re- 
garded as a criminal, and treated as 
such. 
It was only in 1961 that Canadian 
legislation regarding illegal possession 
of narcotics was altered, and the man- 
datory six months minimum jail sen- 
tence of convicted persons revoked. 
This jail sentence was never mandatory 
in Britain. Usually fines, suspended 
sentences, or probation were employed, 
rather than imprisonment. 
Athough certain addicts - notably 
the so-called criminal addicts - are 
normally reluctant to enter hospital for 
treatment, the fact is that in Canada it 
is almost impossible to obtain a hos- 
pital bed (general or psychiatric) for 
such therapy. In Britain it has usually 
been easier for the addict to gain ad- 
mission to and obtain treatment in a 
hospital. Again, the emphasis has been 
on the addict as a sick and dependent 
person, whatever his criminal activities 
may be. 
In Canada today 
The first recommendation of the 
Rolleston Committee (now 40 years 
old) is generally accepted in Canada 
today. In most instances the synthetic 
narcotic methadone hydrochloride is 
used in the withdrawal program. It has 
been demonstrated that over a period 
of from one to three weeks, most nar- 
cotic addicts (heroin being their drug 
of choice) can be safely withdrawn by 
gradually reducing the methadone 
which is substituted for the heroin. 
Since heroin cannot be legally ob- 
tained for any purpose in Canada, it 
cannot be used, though morphine or 
other narcotics may be used as the 
substitute. However, methadone has be- 
come most widely accepted, and, be- 
ginning with an initial dose of about 
40 mg. daily, can be safely and gradu- 
ally reduced until no narcotics are 
being employed. Other drugs - tran- 
quilizers and antidepressants - may 
also be used in conjunction with the 
methadone, and continued as necessary 
after the latter has been discontinued. 4 
But what about the second and third 
40 THE CANADIAN NURSE 


recommendations of the Rolleston 
Committee? How are they to be in- 
terpreted? With our present knowledge 
of the treatment of addicts, both of 
these recommendations are more sub- 
ject to criticism than when they were 
originally advocated. However, it is still 
true that treatment is frequently a dis- 
mal failure, in spite of our opportun- 
ities, and the question of the role of 
narcotic drugs in the therapeutic regi- 
men still remains. 


NAF experiment 
The Narcotic Addiction Foundation 
of British Columbia is a private agency 
engaged in the treatment of the addict 
patient at liberty in the community who 
seeks treatment voluntarily. [n 1963 
the NAF decided to apply the Rolles- 
ton recommendations in the treatment 
of certain selected, and usually older, 
patients whose history indicated re- 
peated failure in therapy. It should be 
noted that drug therapy, though fre- 
quently an essential part of the treat- 
ment and rehabilitative program, is not 
the only, or indeed the main aspect. 
The rationale for the procedures 
used depends on the recognition of the 
addict as physically, psychologically, 
and socially sick. He is a disturbed 
and dependent person, who has gradu- 
ally focused his life around those pro- 
cesses by which he obtains the drug, 
and the gratification he receives from 
it. Further, in most addicts of this 
group the dependency and seU-des- 
tructive needs are so great that to begin 
their therapy without the use of narcot- 
ics (if they are at liberty and not in 
control) would be unthinkable. In other 
words, their motivation is poor, and 
their ability to get along without drugs 
in a reasonable way is minimal. 
We hoped that by administering 
methadone for a longer period, while 
at the same time continuing investiga- 
tion into the physical, social and psy- 
chological problems of the individual, 
and using suitable therapies (medical, 
psychiatric, counseling, re-education, 
job-training, and job-finding, etc.), we 
would be able to help the individual 
to become less dependent on the nar- 
cotic, to reduce or resolve his social 
and emotional conflicts, and gradually 
assume m9re responsibility for him- 
seU. In such a program, the drug - 


comparable in some ways to the pro- 
longed use of tranquilizers or antide- 
pressants in treating mentally ill pa- 
tients in the community - would be 
an essential feature of therapy, and 
would assist many addicts to lead more 
Ilseful and constructive lives. Our ex- 
perience with this method at the NAF 
has tended to confirm the above hypo- 
thesis, and many "hard-core" addicts 
have given up their criminal and anti- 
social behavior under this regimen. 5 
More recently, Dole and Nyswander6 
in New York have experimented with a 
variation of this approach, and while 
results are still tentative, they again in- 
dicate that for some addicts such an 
approach is worthwhile, is less costly 
to the community, and at worst helps 
to prevent many addicts from contin- 
uing and repeating their cycle of 
drugs, criminality, jail, and more drugs. 
Changing attitude 
Since the aforementioned British 
recommendations were proposed, our 
understanding and approach to the 
treatment of the addict has gradually 
moved toward acceptance of him as a 
sick person who needs treatment, what- 
ever other forms of control might be 
desirable. This principle is operative 
even when imprisonment is assigned 
for criminal acts. Within this past year 
a new federal drug treatment center for 
convicted offenders has been opened at 
Matsqui, in the Fraser Valley, British 
Columbia. After screening, selected ad- 
dict offenders are sent to this center 
for treatment and rehabilitative mea- 
sures, which will extend into after-care 
support, with extensive use of parole. 
These measures are the result of a 
changing and more enlightened social 
attitude about the causes and manage- 
ment of addiction - an attitude es- 
sential to more sophisticated social 
action. 
Although this approach to treat- 
ment is helpful to some addicts, it is 
by no means helpful to all. Many 
drug-dependent individuals require ex- 
ternal controls in a clinic or hospital 
setting for some time before they have 
reached the degree of maturity, under- 
standing, and social progress, which 
will enable them to exercise control 
over themselves while at liberty in the 
community. In New York and Califor- 
MARCH 1967 



. 


t 



 


MARCH 1967 


...... 


. 


I 


... 


, 


nia, legislation has been enacted that 
petmits "committal" of suitable addicts 
to such a treatment setting; similar 
legislation is desirable in Canada. 


Conclusion 
The reader is referred to the recom- 
mendations of the Special Committee 
of the Canadian Medical Association, 7 
which spells out the components of 
good medical care in the treatment of 
the addict. These include the following 
advice: "It may, in certain circumstan- 
ces, be good medical practice to pre- 
scribe maintenance doses of narcotics 
for long periods to an addict at liberty, 
if other components of good medical 
care are also provided. If they are not, 
the doctor may be guilty of trafficking. 
Our advice to general practitioners is 
that they should, if possible, avoid 
prescribing narcotics for long periods 
for addicts under their care." 


References 
I. Great Britain. Interdepartmental Com- 
mittee on Drug Addiction. Drug ad- 
diction; the second report. London, Her 
Majesty's Stat. Office, 1965. 
2. Division of Narcotic Control. Ottawa, 
Department of National Health & Wel- 
fare, 1965. 
3. Special Committee on the Traffic in Nar- 
cotic Drugs in Canada. Proceedings, 2nd 
session, 22nd Parliament 3-4 Elizabeth 
II. 1953- I 954. Ottawa. Queen's Printer, 
1955. 
4. Halliday, R. Treatment of the narcotic 
addict. H.C. Med. Joumal, 6: 421, 1964. 
5. Halliday, R. Narcotic drug addicts as 
voluntary patients; the use of metha- 
done on short-term and long-term with- 
drawal treatment programs. Report to 
Committee on Problems of Drug De- 
pendence. National Academy of Sciences, 
Washington. D.C., 1966, p. 4599 (Un- 
published) 
6. Dole V.P. and Nyswander, M. Medical 
treatment for diacetylmorphine (heroin) 
addiction; a clinical trial with methadone 
hydrochloride. J. Amer. Med. Assoc. 
193: 646, Aug. 23, 1965. 
7. Good medical practice in the care of the 
narcotic addict. A report prepared by a 
Special Committee appointed by the Exe- 
cutive Committee of the Canadian Medi- 
cal Association. Callad. Med. Assoc. J. 
1040-1043, May 8. 1965. 0 
THE CANADIAN NURSE 41 



Care of patients addicted 
to non-narcotic drugs 


On admission to hospital, the per- 
son addicted to non-narcotic drugs may 
appear intoxicated; but there is a subtle 
difference between him and the person 
intoxicated with alcohol. The drug ad- 
dict's difficulty in walking is usually 
more marked than his ability to speak 
or comprehend. An alcoholic who 
finds it hard to maintain balance, looks 
half asleep, has incoherent speech, .and 
usually falls into bed and to sleep 
quite quickly. The drug addict, on the 
other hand, has difficulty maneuvering, 
but is much more aware of what is 
going on; although his speech may be 
somewhat slurred, he makes sense. 
Quite often the patient has a mixed 
addiction - to both sedative drugs 
and alcohol - which may be sus- 
pected by his unusual behavior. Fre- 
quently a patient who is admitted for 
treatment of an alcohol problem de- 
monstrates an additional problem by 
begging for a certain kind of drug. 
Staff are always aware of the possi- 
bilitv that a patient is in the process 
of changing his dependence from al- 
cohol to sedatives. From the stand- 
point of clinical management, depend- 
ence on alcohol is the lesser of two 
evils. 


Alcoholics may switch drugs 
Many alcoholics begin to use bar- 
biturates or tranquilizers when, for 
various reasons, they can no longer 
take alcohol without being in trouble. 
One patient who had changed his de- 
pendence from alcohol to pills was 
42 THE CANADIAN NURSE 


Nursing a patient who is addicted to drugs is much more difficult than nursing 
one addicted to alcohol. The drug addict takes longer to withdraw, wants to hang 
onto his chemical beyond reason, is wretchedly uncomfortable, jittery, and 
anxious for days. He tries the patience and ingenuity of the staff to the utmost. 


Mary L. Epp 


brought to hospital by his wife. It was 
a frustrating conference. His wife was 
threatening to leave him, the doctor 
was stressing the dire physical and 
mental consequences of his continued 
use of pills, and his employer was sug- 
gesting that he was in danger of losing 
his job. But he sat there quite happy 
through it all. He was so thoroughly 
tranquilized that he was incapable of 
worry and refused to stay for treat- 
ment. He might have been more ame- 
nable to reason the next morning after 
he had "slept off" some of his sedative. 
Other persons start taking drugs on 
prescription, but increase dosage until 
it is so out of control that they be- 
come intoxicated, fall down frequent- 
ly, and are quite unable to cope. 


Choice of drugs 
The drugs to which a person may 
become addicted include anything that 
can change the way he feels, such as 
Aspirin, A.P.c. & C's, barbiturates, 
tranquilizers, bromide, paraldehyde, 
amphetamines, chloral hydrate, codei- 
ne, morphine, heroin, methadone, De- 
merol, or mixtures of these. When a 
person is becoming dependent on a 
drug he is very careful not to run out 
of his special brand - although he 
may take only a few pills a day. Later 
in the addiction he will not be as par- 
ticular about the type of drug he uses, 
as long as there is plenty. 


Mrs. Epp is Director of Nursing at The 
Bell Clinic in Willowdale. Ontario. 


Clothing and luggage searched 
A good way to admit a patient who 
is addicted to drugs is to take him 
directly to an examining room, where 
he is seen by the admitting doctor 
while his luggage is left elsewhere and 
very thoroughly and carefully search- 
ed. His pyjamas and dressing gown 
are taken to him only after all pockets 
have been checked; his clothes are 
removed from the room and examined 
for drugs. Pills have been found in 
trouser cuffs and billfolds - in fact, 
almost anywhere. A woman has many 
hiding places among her cosmetics. 
The examination of clothing and 
personal effects should be done rou- 
tinely even though the patient seems 
to be sober, is channing and good 
looking, and assures you he has noth- 
ing to hide. At the risk of feeling 
foolish for insisting on this routine, 
you must resist the temptation to escort 
the patient directly to' his room. After 
you have been fooled a few times you 
will be quite matter-of-fact about the 
searching performance even if you 
have to do it in front of the patient. 
These patients are not trustworthy 
while they are undergoing withdrawal 
and we can help them only when they 
realize that they cannot manipulate the 
staff. Actually, most patients expect to 
be searched. 
Some patients arrive with an as- 
tonishing variety of pills scattered 
among their belongings. Besides the 
tranquilizers and/or barbiturates, they 
often have laxatives, diuretics, antacids, 
MARCH 1967 



,
 


l 


MARCH 1967 


-\ 


" 


- 


pills for hypertension, etc. It is im- 
portant to take every pill away. After 
consulting the family physician, the 
staff doctor will decide which ones, 
if any, the patient requires. 
Withdrawal routine 
During treatment, we are careful 
to avoid transferring a patient's de- 
pendence to another type of pill. This 
is particularly true when treating pa- 
tients with a drug that demonstrates 
cross-tolerance with the addicting drug. 
Patients are told that they will have 
to put up with some discomfort. If 
they are made as comfortable on the 
new pill as they were on the old, they 
will never recover. 
At the beginning of treatment a 
drug addict finds it difficult to coop- 
erate. Do not expect him to tell the 
truth about his addiction. To plan the 
treatment of his withdrawal reaction 
it may be important to know how 
much he has been taking; however, 
you cannot rely on what he tells you. 
This may be partly because he is 
ashamed of his addiction and partly 
because he quite truthfully does not 
know. It is a well-known fact that 
many so-called suicides are the result 
of unintentional overdose. The addict 
forgets how much sedative he has 
taken or is too impatient to wait for 
the drug to take effect. 
Barbiturates 
If the patient has been taking large 
amounts of barbiturates for a long 
THE CANADIAN NURSE 43 



time, he may have a convulsion on 
abrupt withdrawal in spite of treatment 
with anticonvulsant drugs. Under these 
circumstances the physician usually 
withdraws the barbiturates gradually 
and administers both tranquilizers and 
anticonvulsants concurrently. If the 
patient is addicted to a tranquilizer, he 
is usually switched to another tran- 
quilizer at once and the dosage is 
gradually reduced to zero. 
Paraldehyde 
Paraldehyde makes an alcoholic feel 
wonderful. It is a derivative of alcohol 
and much stronger. To many alcoholics 
who have learned to put up with the 
taste and smell, this is the drug of 
choice on withdrawal. The odor. of 
course, is unmistakable and the nurse 
can only hope that when a patient is 
admitted smelling of paraldehyde, it 
has been prescribed for him, and not 
taken voluntarily for its "welcome" 
effects. In the latter case there may 
be considerable difficulty withdrawing 
the patient from his drug. 
Amphetamine 
The withdrawal reaction of the am- 
phetamine addict is in sharp contrast 
to that of the addict to sedative drugs 
or alcohol. He is very sleepy and dull 
and complains of having difficulty in 
thinking. If he is presumed to be an 
amphetamine addict and does not 
behave in this way, we may suspect 
a mixed addiction, that he has some 
concealed supplies, or that he plans a 
trip to the drug store at the first op- 
portunity. 
Support from staff 
A great deal of time is spent by 
the staff in reassuring and getting ac- 
quainted with patients in the first 
stages of a recovery program. Persons 
addicted to drugs need to learn to de- 
pend on people rather than chemicals 
and they start with a new dependence 
on the hospital staff. When this shift 
in dependence begins, the staff must 
be prepared to accept it for a pro- 
longed period, sometimes years. while 
hopefully the patient learns to depend 
on other people as well. 
44 THE CANADIAN NURSE 


Patients may choose a particular 
member of the staff as their "mentor." 
Care must be taken to maintain a 
professional, although friendly, atti- 
tude. A rule that patients are seen only 
at the clinic or hospital and that phone 
calls all take place while the nurse is 
on duty is a stabilizing influence. No 
staff phone numbers are released to 
patients 
Sitting down and chatting with the 
patient will help to pass the time for 
him and also give you a better idea of 
just how the withdrawal is going. Pa- 
tients may put on a show to get more 
pills or more attention. We must try 
to understand that they are probably 
afraid of life without their chemical 
comfort. Sometimes a patient can be 
helped to appreciate his situation by 
comparing his continuous drug intoxi- 
cation to a big downy comforter which 
he has wrapped around himself as pro- 
tection from all his problems. As he 
is withdrawn he becomes naked and 
vulnerable and is hurt over and over 
again. A scolding from his wife, loud 
noises, the idea that he may have 
damaged himself permanently, all hit 
him with nothing to cushion the blow. 
With growing awareness that the 
staff is capable and really wants to 
help him, the patient becomes less 
apprehensive about being withdrawn 
from his chemical comforts. During 
the withdrawal period he desperately 
needs attention and kindness, and often 
finds it hard to believe that the nurse 
cares what happens to him. Your con- 
cern and belief that he can be better 
gradually penetrates and he begins to 
have some hope that life without pills 
is possible - if not too acceptable 
at first. 
It is amazing how soon patients 
want to get up and around. They will 

et cleaned up as well as they can and 
ioin the other patients ño matter how 
they mav feel or how shaky and un- 
steady thev are. Sometimes the staff 
mav fear that these patients will fall 
or disturb other patients; but it would 
seem that the comfort they get from 
being with others, even thoue:h they 
may - be dozing part of the time, as- 
sists the withdrawal process. 


Visits after discharge encouraged 
Persons who have been discharged 
from hospital are encouraged to visit 
the staff regularly. Most ex-patients 
particularly enjoy a chat with their 
favorite nurse, but anyone is better 
than no one. Other members of the 
staff, therefore, must be prepared to 
help if someone's patient phones or 
visits when she is off duty. He may 
be unhappy and jittery and will need 
to be encouraged to put up with the 
way he feels for the time being. We 
hope that he will learn, too, that talk- 
ing with any understanding person can 
be of help. This points up the neces- 
sity for regular staff conferences, as 
well as the importance of recording the 
nurses' conversations about patients. 


Not all recover 
Unfortunately, some persons are so 
emotionally disturbed and so chroni- 
cally uncomfortable that they are 
unable to function in society at all 
without some chemical dulling of un- 
pleasant reality. For such patients, 
the smallest dosage which will enable 
them to carry on is maintained. It 
may be necessary to change the kind 
of medication occasionally as their 
tolerance for one kind builds up. 


Conclusion 
It is important for nurses to realize 
that although it may take a great deal 
of effort and a long time, it is pos- 
sible to help most people to learn to 
live without sedative drugs and to be- 
come more comfortable through im- 
proved communication with others. 0 


MARCH 1967 



I am employed as a nurse in the 
Small Animal Surgery at the Ontario 
Veterinary College in Guelph, Ontario. 
How did I get here? Almost acci- 
dentally. 
In the fall of 1964, I heard by the 
grapevine that the services of a nurse 
were being considered for the operating 
room at O.V.c. Because of my interest 
in animals and the enticement of regu- 
lar hours of work, I investigated. At 
the time, I had been on the staff of a 
Guelph hospital for 10 years since my 
graduation as a registered nurse in 
1949. I am married, have two teen- 
age sons, and. of course. a dog and cat. 
Many patients referred 
In the Small Animal Department at 
the Veterinary College, there is a hos- 
pital and outpatient clinic for the pub- 
lic. All pets of local residents are 
received on appointment, examined by 
a clinician on staff, and given treatment 
or hospitalized as inpatients. 
Many difficult cases are referred to 
the clinic by out-of-town veterinarians. 
Animals are sent here from all over the 
country, from as far west as British 
Columbia, and as far east as the Mari- 
time provinces. Many, too, are natives 
of the United States. 


A variety of patients 
Our patients include grand champi- 
on show dogs, field trial dogs, and 
many good old lovable mongrels. Cats, 
too, are represented on our patient list. 
Occasionally our feathered friends 
MARCH 1967 


Deserter of people? 


"Few nurses have patients like mine, which include grand champion show dogs, 
lovable mongrels, cats, and even a few feathered friends." 


Jean Wilkinson 


-... 


, 


--"" 


Mrs. Wilkinson is nurse in the Small 
Animal Surgery at the Ontario Veterinary 
College jp Guelph. Ontario. 


require treatment. An old grey owl had 
a broken wing pinned successfully; a 
snow goose had a tumor removed; and 
a peacock and homing pidgeon re- 
quired medical care. Birds are poor 
anesthetic risks, however, and rarely 
become surgical patients. 
Animals have many of the same 
diseases as man plus some peculiar to 
themselves. The following operations 
are done on dogs and cats: tonsillecto- 
my. splenectomy, cystotomy, lobecto- 
my, diaphragmatic hernia repair, tho- 


racotomy, kidney transplants, open- 
heart surgery, thoracic surgery, lami- 
nectomies, and all types of orthopedic 
surgery. Pins and plates are used al- 
most daily in some unfortunate dog 
who has met an accident with a car. A 
fractured femur, radius, tibia, pelvis, 
etc., can be pinned or plated success- 
fully and "Fido" will be up and run- 
ning about on all four legs in a matter 
of a few weeks. 
Occasionally we have a cesarean 
section. It's quite exciting when several 
people are "puppy rubbing" the small 
pink-nosed puppies who squeak loudly 
at this indignity. After the mucous is 
removed from nose and mouth, the 
newborn is placed in a heated box with 
several brothers and sisters - any 
number, from one to nine. 


Strict aseptic technique in O.R. 
The surgery here is modern, air-con- 
ditioned, and well-equipped. We have 
three operating rooms plus a scrub 
room and working area. The operating 
suite could be compared to one in a 
small hospital. The most stringent asep- 
tic technique in operating room pro- 
cedure is carried out for all animals. 
Doctors scrub, gown, and glove. 
Before the animal is brought in, his 
operative area is shaved and the skin 
cleansed with antiseptic. Dogs and cats 
are anesthetized and wheeled in on 
stretchers. The most common anesthe- 
tic for these animals is Nembutal. given 
intravenously. Sodium Pentothal and 
Surital are used intravenously for mi- 
THE CANADIAN NURSE 45 



The operating rooms for small animal 
surgery are nwdern, air-conditioned, 
and well-equipped. 


Strict aseptic technique is carried out 
for all types of surgery. 


... 


-...... 


--" 


. 



 


\. 


l 


'- 


--- '.. 


46 THE CANADIAN NURSE 


nor surgery and for anything that re- 
quires a short-acting anesthetic. 
We have two large anesthetic ma- 
chines for f1uothane inhalation, used 
mainly on older dogs that are poor 
anesthetic risks, or for animals that 
require thoracic surgery. The animals 
are all intubated with endotracheal 
tubes for a clear airway during anes- 
thesia, and then are draped with sterile 
drapes, the same as in operating room 
procedures for a human. 
A central service department cleans 
and sterilizes instruments, drapes, and 
equipment. Most of our surgery is done 
in the afternoon since this is a teaching 
university. The mornings are free for 
lectures and clinic office hours. 
Very few patients are lost during 
surgery. Intravenous stimulents, oxy- 
gen, and respirators are available if 
needed. The use of intravenous saline 
dextrose and whole blood transfusions 
is common. 


Research 
The research work done in this de- 
partment may be of help in human 
surgery some day. I have had a small 
part in helping with some work done 
on research of bone healing. This was 
carried out on rabbits as a postgraduate 
study. Another beneficial research pro- 
gram is one that has been done on 
Legg-Perthes' disease. This may prove 
beneficial to children. Hip prosthesis 
was pioneered on dogs a few years ago. 
Not a deserter of people 
I noticed that a reporter headlined 
me in a column last year as a "deserter 
of people." However, I still have a 
close relationship with people through 
their family pets. Pet owners are a very 
devoted lot. They like to see their pet, 
who is just like one of the family, get 
the very best care possible. If I am 
helping in some small way to do this. 
then I have not let "people" down. 0 


MARCH 1%7 



Imagine if there were ten ways to 
tell time. Suppose half the people on 
highways drove on the left side as 
a matter of choice. What if there was 
a dispute as to whether to stop or go 
on a red light. 
It is obvious that many things that 
we take for granted in our lives have 
been standardized for convenience and 
safety. 
There is even considerable stan- 
dardization within individual hospitals. 
However, there is little standardiza- 
tion from hospital to hospital, and 
this creates problems. One special 
aspect of this is standardization of 
medical-surgical supplies and equip- 
ment. As early as 1931 the United 
States government set up a committee 
to investigate this, but the battle to 
standardize has been a losing one. 
There are still as many techniques of 
doing a procedure as there are doctors 
and nurses in a hospital. 
One example from a manufacturer 
concerns needle sizes. "There are few 
doctors or nurses who would know any 
difference between a 20-gauge, 1 h- 
inch needle and a 21-gauge, 1 
 -inch 
needle if they did not read the label. 
Yet there are as many different sizes 
as there are users in some hospitals !" 
One hospital had been using 10 
different sizes of needles; a product 
manager convinced the staff to use 
just three standard sizes for a one- 
month trial. One month later they 
wondered why they had ever needed 
all the other sizes in the first place. 
Individual preference 
The individual doctor, by law, is 
MARCH 1967 


Stan dard ization 


Many things we take for granted have been standardized for our convenience 
and safety. Would greater standardization in products and procedures 
help our patients? 


George T. Maloney 


Mr. Maloney is Vice-President in charge 
of Merchandising for C.R. Bard, Inc., 
Murray Hill, New Jersey. This article is 
adapted from a speech presented to the 
Mid-West Hospital Association Annual 
Convention in Kansas City last fall. 


allowed to practice the art of healing 
according to his own discretion. More 
uniformity in teaching in medical 
schools would help to reduce the 
various whims of the individual doc- 
tor. The same applies to nursing 
schools. 
Today, commercially prepareä, pre- 
packaged, preassembled, presterilized 
tray setups are coming on the market. 
A host of manufacturers are preparing 
them. These people recognize the im- 
portance of the concept of a standard 


"for one and for all" if there is to be: 
· more convenience 
· better service 
· smaller inventories 
· assured quality 
If hospitals will not accept a stand- 
ard setup they will get greater ag- 
gravation. 
Nurses may already have experienc- 
ed some of the problems associated 
with specially-prepared sets. "It's 
late!" "Something's missing!" "They've 
used the wrong item!" Then it begins 
- phone calls, questions, answers, 
promises, explanations. 
How efficient would any central 
service be if it had to prepare 10 to 
20 variations of the same setup? How 
much higher are costs when special 
parts must be purchased for the varia- 
tions as opposed to the cost-saving 
of quantity purchase? How much 
more storage space is required if sever- 
al variables of an item must be stocked 
according to glove size, needle size, 
syringe size, and so on ? 
Compound these problems by 
1,452* hospitals in Canada and you 
have an idea of the number of poten- 
tial problems facing manufacturers 
and dealers. 
High costs of specials 
Manufacturers, because of compe- 
tition, have catered to these individual 
preferences and have made "specials." 
In other words, the salesman is told 
that if the tray is not prepared special- 
ly for that hospital, it will be ob- 
tained from another manufacturer. 


*Dominion Bureau of Statistics, List of 
Canadian Hospitals (83-201) 1965, p. 6. 
THE CANADIAN NURSE 47 



However, if this trend continues, 
prices will have to rise. 
An excellent analogy is what has 
happened in the automotive industry. 
From Henry Ford's "I'll paint it any 
color as long as it's black" concept, 
there is now a huge range of models. 
A spokesman for Ford stated that 
it is conceivable that they could go 
through an entire year without making 
two identical automobiles. It does not 
take much "gray matter" to under- 
stand the reason for the high cost of 
an automobile. Many people believe 
that as volume goes up, price comes 
down. The converse of this is true in 
the automobile industry because most 
cars are "specials." 
Hospitals often fail to understand 
the reason for a higher price on a 
special. For example, if their special 
is created by removing a part, some 
believe that the price of the tray 
should be reduced proportionately. 
What has to be taken into considera- 
tion is not only the cost of the part; 
when there is deviation from a stand- 
ard product, closer supervision and 
more production training is necessary 
because more problems are created. 
With a standard product, prod- 
uction follows a pattern and those 
involved develop a greater degree of 
skill. This naturally leads to greater 
ease in training employees, and 
greater proficiency of work. Also, aU 
manufacturing costs, particularly low 
labor and inventory costs, mean less 
money tied up in production. The 
customer then receives a quality 
product at a lower price. 


Standardization will come 
Manufacturers, doctors, nurses, and 
hospitals are all in the business of 
providing safe, effective, quality 
patient care. Standardization will 
help, but all will have to coordinate 
efforts to achieve it. 
First, simple, honest communica- 
tion is essential. At many a conven- 
tion, someone has stopped by our 
booth and requested a "speciaL" After 
he has been told about the time, 
trouble, and expense necessary, and 
that there was no guarantee that the 
product would satisfy, he invariably 
expressed thanks and understanding 
of the problem. 
Second, a natural evolution will 
occur, because neither the hospital 
nor the dealer will be able to eval- 
uate all the new products introduced 
each year. Dealers will influence the 
tendency to standardization. They do 
not have the space for four variations 
of the same tray, nor the time to learn 
the selling features. The space pro- 
blem need not be elaborated as every- 
one is aware of the problems of keep- 
48 THE CANADIAN NURSE 


ing up with space demands caused 
by disposables. However, the cost 
and disadvantages of returning to 
reusables is obvious. As the fellow 
said: "Horse travel doesn't cost as 
much as going by jet, but who is going 
to travel by horse?" 
To be profitable, disposable business 
must be done on a volume basis. Com- 
petition will eventually force manu- 
facturers to standardize or get out 
of certain areas. 
Third, the introduction of electro- 
nic equipment and items such as the 
dataphone will help to bring stand- 
ardization. Recently, eight hospitals 
in an area organized to share com- 
puter facilities to improve patient ser- 
vice and hospital administration. The 
new system will help control inven- 
tories of more than 2,500 different 
stock items and will provide greater 
economies in supply purchase. These 
eight hospitals have had to come to 
agreement on basic items. 
Fourth, labor problems will also 
bring standardization more quickly. 
Hospital rates are rising rapidly as 
higher salaries are obtained by nurses 
and other hospital employees who 
have been underpaid in past years. 
Hospital administration will aim for 
increased efficiency and one way will 
be through increased standardization. 
A fifth factor affecting standard- 
ization is that the practice of medi- 
cine is changing. Dr. Oscar Creech, Jr., 
Professor of Surgery and Chairman of 
the Department at Tulane University 
School of Medicine, recently predicted 
that by 1990 medicine will be prac- 
ticed on an assembly-line basis. He 
pointed out that neither patients nor 
physicians are ready for such changes, 
but radical changes in the practice of 
medicine are inevitable and the pro- 
fession must prepare for them so as to 
dictate in some measure how they will 
occur. Standardization of equipment 
and supplies will play a part if this 
prediction becomes reality. 
In the United States, the Federal 
Government is becoming increasingly 
involved in the medical industry, and 
with Medicare it will become even 
more concerned with costs. It is to be 
hoped that the industry itself will un- 
dertake cost control and not invite the 
government to take over. 


Manufacturer's goals 
Manufacturers must meet the crite- 
ria of quality of the medical industry 
in all products. Each item must be of 
a quality that is adequate for its spe- 
cific purpose. Therefore, the purpose 
must be spelled out before work can 
begin on a product. Again, communi- 
cation between user and manufacturer 
is essential as trial and error evalua- 


tion help to elucidate additional factors 
and more useful methods. 
Many techniques of communication 
may be used: 
1. Questionnaires are devised for 
each specific product. These are kept 
simple and concise, but include a com- 
ment section. Some questionnaires are 
sent by an agency so that the manu- 
facturer's name is not used; others are 
designed to be used by salesmen during 
a "market test" phase of a product. 
2. Consultants are sent to approxi- 
mately 100 hospitals to check out var- 
ious aspects of a product in the actual 
situation. Monthly reports are sent in 
on the product. 
3. Recently, an advisory panel has 
been used effectively. The panel for 
an item used in nursing would include: 
five nurses from the nursing adminis- 
tration office (either the director or her 
associates); three operating room su- 
pervisors; nine central supply super- 
visors; one nurse from the intravenous 
team; one nurse with special interest in 
research and development; and one 
purchasing agent. 
The panel meets for a day to pre- 
sent concepts and prototypes and to 
evaluate existing products. The atmos- 
phere is relaxed and informal and cri- 
ticism is encouraged. 
4. Organization within the industry 
can also help. A new group of market- 
ing people from 31 companies held a 
meeting at which competitors sat to- 
e-ether and agreed that they could, and 
should, work together toward certain 
aspects of standardization. 


Identical goals 
Standardization will benefit patient 
care, but it needs cooperation and 
communication and time. 
In a recent editorial in the Journal of 
the American Hospital Association ma- 
gazine, Hospitals, it was stated: "A 
need exists for more standardization, 
simplification, higher standards, bet- 
ter communication, more efficient 
marketing techniques, and more co- 
operative efforts by hospitals and in- 
dustry to develop products for hospital 
use... Better communication between 
hospitals and supply firms is also 
needed about product research and 
development and also use of equip- 
ment and supplies in patient care... 
Hospitals should not only be willing 
to assist industry by discussing in use, 
patient-care factors that may affect 
proper design, but also should realize 
that this is a continuing responsibility 
of the hospital field. Industry, on its 
part will find that involving profes- 
sional and hospital personnel early in 
the development stages of hospital 
equipment will be advantageous..." 
This sums it up quite solidly. 0 
MARCH 1967 



Hospital and health care 
- what price? 


Almost daily, news media make 
Canadians aware of skyrocketing hos- 
pital costs. While all this informa- 
tion is of great interest to the indi- 
vidual, it unfortunately fails to reveal 
how much of the total cost is diverted 
from one's personal income. If one 
considers all the various types of taxes 
to which one's income is subjected, 
it becomes clear that it would be an 
exercise in futility to attempt to com- 
pute any given individual's share of 
hospital costs. 
Hospital operating costs 
Public general hospitals, with few 
exceptions, come under provincial 
jurisdiction. It is left to provincial 
governments to negotiate with hos- 
pitals, individually, to determine the 
amounts that each hospital is entitled 
to receive in order to offer hospital 
care to those requiring it. 
However, in the Canadian system 
of taxation the federal government 
collects a part of the taxes earmarked 
to pay hospital costs, which in turn 
are transferred to the provincial gov- 
ernments. As the amounts received 
from the federal government cover 
approximately half (depending on the 
province involved) of shareable hos- 
pital costs, it remains to the province 
to raise most of the remaining balance. 
This is accomplished through various 
tax-raising programs and, in some 
provinces, through direct contribu- 
tions from individuals. 
In some provinces, authorities may 
MARCH 1967 


Often we are informed that the local hospital's costs have increased 20 percent 
in the past year. This raises the question of how much each individual 
is going to have to supply to cover the increase. 


S. J. Maubach, B. Comm., CA. 


raise funds to reimburse hospitals for 
their costs through a combination of 
the foregoing methods. For instance, 
in Ontario a married man must pay, 
or have paid on his behalf, $6.50 
per month to the provincial plan for 
prepaid hospital care. However, the 
total collected by the province in this 
manner is insufficient to provide 
enough funds to reimburse hospitals 
for the province's share of costs and 
it therefore becomes necessary to al- 
locate monies gathered from some 
other source to the hospital cost pool. 
In Quebec, individuals do not make 
direct payments to the provincial 
government in the form of premiums; 
the provincial government's share of 
hospital costs is financed through 
general tax programs. In British 
Columbia, yet another innovation is 
found. Each hospital patient must 
pay one dollar per day to the hos- 
pital while he remains in the institu- 
tion, in addition to the amount he 
pays to the government. 
Here then we see the individual 
may pay for hospitalization to three 
parties: the federal government, the 
provincial government, and the hos- 
pital in which he becomes a patient. 
These are but a few examples to il- 
lustrate how complicated it would be 
for any individual to determine how 
much one actually does pay toward 
hospital costs. 


Mr. Maubach is Lecturer, School of Hos- 
pital Administration. University of Ottawa. 


Furthermore, it must be noted that 
most provinces do not reimburse each 
hospital its total costs incurred in 
the treatment of patients. For in- 
stance, in all provinces except Mani- 
toba, depreciation on hospital buil- 
dings must be absorbed by the hos- 
pital. Interest on capital debt is not 
generally covered in reimbursement 
formulas except in Alberta and Mani- 
toba. 


Hospital capital costs 
Up to now mention has only been 
made of the funds required in the day- 
to-day operations of the hospital. 
Where does the money come from to 
build the hospital in the first place? 
As with operating costs, both federal 
and provincial governments are invol- 
ved in financing part of the capital 
required to construct and partially 
equip hospital facilities. 
These two levels of government 
combine to underwrite, in most cases, 
a large portion of the total cost; the 
amount varies from province to pro- 
vince. However, the federal program 
is constant for each project. It is there- 
fore left to most hospitals to find other 
sources of funds to finance that por- 
tion of capital costs not provided for 
by federal and provincial authorities. 
These funds are derived from several 
possible bodies - municipal govern- 
ments, philanthropic organizations, 
religious orders operating the hos- 
pitals, and, needless to say, you and I. 
THE CANADIAN NURSE 49 



Federal 
Government 


Taxes 


Tax-Shared Programs 


Provincial 
Government 


Individual 


Charges 
Not Paid by Plan 
Donations 


Prope y Taxes 


Municipal 
Government 


Religious 
Bodies 


CHART 1 


Philanthropic 
Bodies 


Source and allocation of 
hospital funds 
It might be well to follow the flow 
of funds to their final destination - 
the hospital. Taxes collected by the 
federal government are passed on to 
the provincial governments under an 
established formula. This money goes 
into a provmcial hospital pool. The 
provincial government raises money 
from taxes or premiums, or both, and 
these are also allocated to the hospital 
pool. This pool of funds is then distri- 
buted to individual hospitals based 
on a negotiated budget, or other 
similar planning and control devices, 
which is meant to repay the hospital 
for approved costs incurred in treat- 
ing patients in a standard ward. 
Should the patient prefer accommoda- 
tion superior to that of the standard 
ward, it is necessary that the indivi- 
dual pay an extra fee to the hospital. 
These extra funds obtained by the 
hospital are sometimes shared with 
the province and the portion retained 
by the hospital is meant, in part, to 
cover losses suffered by the institu- 
tion. (Chart. J.) 
Not to be forgotten are those hos- 
pitals which serve the outpatients of 
50 THE CANADIAN NURSE 


A Public General 
Hospital 


the community. In varying degrees, 
most of the provincial plans do not 
reimburse the hospital for the entire 
costs, sometimes substantial, incurred 
in rendering this service. 


Table 1 


Projected 1966 Expenditure on 
Personal Health 
Services and Facilities] 
Cost 
Per Capita 


Service 


Physicians 
Dentists 
Other Health Services 
Health Insurance Admin. 
Prescribed drugs 
Hospital Services 
TOTAL SERVICES 
HEAL TH FACILITIES:! 
TOTAL 


$ 24.91 
8.00 
7.14 
4.68 
7.56 
73.89 
$126.18 
8.27 
$134.45 


I. Royal Commission on Health Services. 
Volume I. Queen's Printer, 1964, p. 843. 
2. Ibid., p. 851. 


Other health facilities 
While this article has so far been 
restricted to the hospital field, some 
reference should be made to other 
health care costs in order that some 
idea may be given of the magnitude 
of the total health care picture which, 
directly or indirectly, must be paid 
for by the tax-paying public. 
The anticipated cost of health care 
in Canada in 1966 shows that $134.45 
would be spent for every man, woman 
and child. While the major portion 
goes to hospital services, $60.56 per 
man, woman and child will go to other 
services and health facilities. (Ta- 
ble J.) 
While the figures in the table give 
a rough indication of total health 
care costs, it should be pointed out 
that they are shown on a per capita 
basis. If you happen to earn higher 
than average income, your share of 
the cost is substantially higher. 
Even though it now appears impos- 
sible to determine how much we, as 
individuals, pay toward hospital and 
other health care costs, we undoubted- 
ly receive much better care than our 
forefathers did. However, in view of 
the rapidly changing nature of health 
services offered to us, the day will soon 
arrive when the politicians, health 
care leaders and the Canadian public 
must determine how much income is 
being spent and should be spent for 
our well-being. 0 


MARCH 1967 



research abstracts 


The following are abstracts of studies 
selected from the Canadian Nurses' As- 
sociation Repository Collection of Nursing 
Studies. Abstract manuscripts are prepared 
by the authors. 


Buchan, Irene M. A Study of inadive 
nurses in Alberta, Canada, to determine 
selected characteristics, reasons for in- 
acti,'ity, and the extellt to which they 
represellt a potential nursing resource. 
Seattle, 1966. Thesis (M.N.) University 
of Washington. 
The study was done to determine: l. the 
characteristics of inactive nurses; 2. the 
reasons for their inactive status; and 3. the 
extent to which inactive nurses planned to 
return to full-time or part-time nursing 
employment. 
Data were gathered by a questionnaire. 
The respondents comprised 374 inactive 
nurses in Alberta. Data from the question- 
naires were tabulated according to four 
categories: l. nurses who had already re- 
turned to active nursing; 2. inactive nurses 
who planned to return to active nursing; 
3. inactive nurses who were uncertain about 
returning to active nursing; and 4. inactive 
nurses who did not plan to return to nur- 
sing. In order to present a composite 
picture of the inactive nurse, data from 
the questionnaires of the latter three 
categories were tabulated and analyzed. 
Questionnaires of 43 nurses who were al- 
ready re-employed were deleted from the 
study, leaving a total of 331 inactive nurses 
as the study population. 
The findings indicated that the respon- 
dents represented a considerable potential 
nursing resource. A composite picture of 
the inactive nurse was presented. 1 he three 
main reasons for inactivity given by the 
majority of the non-practicing nurses were 
concerned with home and family respon- 
sibilities, arrangements for care of children, 
and personnel policies. Recommendations 
for further study were made. 


Neylan, Margaret S. The del'elopment 01 
an e,'aluation Q-Sort; a study of nursing 
instructors. Vancouver, 1966. Thesis 
(M.A.) University of British Columbia. 
The purpose of this study was to develop 
an Evaluation Q-Sort and to test it by 
measuring the perceptions held by nursing 
instructors on the relative importance of 
five functions and effects of evaluation. 
The functions and effects identified for 
study were: the measurement of student 
achievement; the measurement of student 
MARCH 1967 


progress; psychological effects of evalua- 
tion; the influence of evaluation on teach- 
ing; and the influence of evaluation on 
administration. An Evaluation Q-Sort was 
developed and used to measure the percep- 
tions of evaluation held by the III nursing 
instructors in the 6 professional nursing 
schools in the Lower Mainland and Van- 
couver Island areas of the Province of 
British Columbia. 
The population was divided into 10 clas- 
sifications according to various criteria 
related to role, experience, preparation, and 
instructional setting. The central hypothesis 
assumed that the group of instructors as a 
whole would not assign greater importance 
to anyone of the 5 functions and effects 
of evaluation. The 9 sub-hypotheses assum- 
ed that the perceptions of evaluation held 
by nursing instructors would not be in- 
fluenced by the variables selected for study. 
The .05 level of significance was used in 
the study. 
The results indicated that the nursing 
instructors did ascribe significantly dif- 
ferent degrees of importance to the 5 func- 
tions and effects of evaluation. Measure- 
ment of student achievement was ascribed 
least importance and measurement of stu- 
dent progress was ascribed most importance 
among the functions and effects studied. In 
addition, differences were found with res- 
pect to the nature of the instructors' res- 
ponsibilities, the type of school in which 
she taught, and her stated level of satisfac- 
tion with preparation as an evaluator. No 
differences were found with respect to 
length of experience in nursing service or 
education, preparation as an instructor, 
course in tests and measurements, instruc- 
tional focus, and instructional setting. 


Arpin. Kathleen. A study to identify dif- 
ferences, on selected factors, between 
uni,'ersity-qualified students who are 
enrolled in the first year of a bac- 
calaureate or a diploma program in 
nursing. Boston, 1965. Field Study, 
(M.S.) Boston University. 
The study was undertaken to identify 
the differences, on selected factors, be- 
tween university-qualified students who were 
enrolled in the first year of a baccalaureate 
program or a diploma program in nursing. 
The subjects selected for study were 
students enroIled in the first year of two 
baccalaureate programs in nursing and uni- 
versity-qualified students in one diploma 
school of nursing. The schools taking part 
were located in large metropolitan cities 


in approximately the same geographical 
area. 
Data were coIlected by means of a mail- 
ed questionnaire, administered by faculty 
members, which was developed to obtain 
information on the student's social class, 
social background, educational background, 
reasons for selection of school, interest 
in further education, and other related 
factors that might influence a student's 
selection of a particular type of school. 
The responses to the questions were com- 
pared and the differences and similarities 
described. 
The findings indicated that there were 
differences and similarities between the 
two groups. The major areas of difference 
were in social class, reasons for selection 
of school, interest in further education. 
and in social background on the items relat- 
ed to parental attitude toward university 
education. There was little or no difference 
between the two groups on the remaining 
items used to gain information on social 
background, educational background, and 
on the other related factors that might have 
influenced a student's selection of a parti- 
cular type of program. 
Recommendations include: l. that a 
more definitive study of all students in 
grade 13, who have been accepted in either 
a baccalaureate or a diploma program, be 
done to determine the differences between 
the two groups, and 2. that a study of 
parents of grade 13 students who have been 
accepted in either a baccalaureate or a 
diploma program be done to determine 
their attitude toward university education 
for their daughters as compared to the 
students. 


Lennie. Clara May. A study of student 
achie,'ement in an A Iberta hospital school 
of nursing in relation to selected char- 
acteristics of the mother. Seattle, ]965. 
Thesis (M.N.) Univ. of Washington. 
The purpose of this study was to explore 
the relationship between achievement of 
the student nurse in a diploma program 
and selected characteristics of the mother. 
A questionnaire, given to 236 second 
and third-year students, provided informa- 
tion about the mother's characteristics and 
other biographical data. School records 
were reviewed for student achievement. 
The data revealed little relationship 
between the achievement of the student 
nurse and characteristics of the mother as 
measured by her preparation as a nur
e or 
(Continued on page 52) 
THE CANADIAN NURSE 51 



research abstracts 


(Continued from page 51) 
in a related health field, level of education, 
present and past occupation, income, and 
by the mother-daughter relationship. There 
was some indication that the younger, 
single student who entered nursing directly 
from the parental home in which both 
parents were living together, received higher 
grades in nursing fundamentals, micro- 
biology, and pharmacology II. The older 
student obtained higher grades in introduc- 
tion to disease, and medical-surgical nur- 
sing. When mothers were employed before 
marriage, daughters did better in social 
sciences. Students from larger families, 
daughters of mothers employed part-time, 
daughters of mothers currently employed 
in a hospital, and daughters who thought 
parents should guide them in career choice, 
received higher grades in several measures 
of achievement. 


Baribeau, Pierrette. A study of expressed 
attitudes of Lamaze fathers toward labor 
and deli\'ery experience. Boston, 1964. 
Thesis (M.Sc.) Boston University. 
This exploratory study is concerned with 
the father's attitude toward the labor and 
delivery phase of his wife's pregnancy. 
The investigation was conducted within the 
realm of the Lamaze method of childbirth. 
It was assumed that by defining the father's 
role during this important event, the Lamaze 
method was contributing to the reduction 
of the father's anxiety by an increased feel- 
ing of participation. 
The sample included six fathers whose 
wives had had a succesful labor according 
to the Lamaze method. The fathers were 
present only during the labor period. Four 
of the fathers were doctors, one was an 
architect and the sixth was an assistant 
researcher. Three were having their second 
or third experience with the Lamaze 
method of childbirth; for three, it was 
their first experience. 
The method of data collection was a 
partially structured interview with open-end- 
ed questions. The interviews were conduct- 
ed in offices, restaurants or in waiting- 
rooms. The responses were recorded verb- 
atim with the aid of a tape recorder. 
The data were analyzed in relation to 
the father's attitude toward childbirth, 
labor, role perception, and the influence 
of his participation on these attitudes. 
In conclusion, it appears that the Lamaze 
fathers, as they gained more experience 
with the method, also gained more confi- 
dence in the value of their participation. 
They expressed less anxiety verbally and 
in their reported behavior as long as they 
were allowed to be with their wives to assist 
them. They agreed that the Lamaze method 
52 THE CANADIAN NURSE 


is a support to the father because of the 
knowledge given, the defined task, and 
the rationale for active participation of 
the husband in the childbirth process. Some 
fathers expressed the belief that having 
something to do was a help to them. Their 
encounter with the Lamaze method left 
them with a feeling of satisfaction and a 
positive attitude toward childbirth. 
Consequently, it is recommended that 
prenatal classes should stress the import- 
ance of usefulness of the father in the 
antepartal and partal period. Such classes 
should include, beside the usual knowledge, 
a better delineation of the father's role. 
Nurses should be aware of the father's 
need for a role definition and be prepared 
to supply such information. Furthermore, 
a study should be made to ascertain the 
degree of decreased anxiety experienced 
by the Lamaze fathers as compared to 
the amount of anxiety of other prepared 
fathers. 


McKinnon, M. Barbara, Sister. Coordination 
within tire educatioMI program in hos- 
pital schools of nursing. London, 1965. 
Thesis (M.Sc.N.) Univ. of Western 
Ontario. 
This study was designed primarily to 
determine the need for greater coordination 
within the educational program as perceiv- 
ed by directors, teachers, and head nurses 
participating in selected hospital schools 
of nursing programs. The project investi- 
gates four main aspects of coordination, 
namely: 1. the perceived need for coordina- 
tion, the degree of this need, and the 
reasons underlying it; 2. the functions that 
may conceivably be included in coordina- 
tion; 3. an assessment of how well coor- 
dination is currently carried out; the re- 
cognized need for modification of activities, 


Toul!h 


The 900 people who have 
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Service Overseas took on a 
tough job. Long hours. Little 
money. But the reward was 
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Now it's your turn. Write 
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and how this modification may be effected; 
4. the persons deemed most suitable to 
effect coordination, and their desirable 
qualifications. 
Since only 5 of the 63 diploma schools 
in Ontario employ an educational coordin- 
ator, it seemed pertinent to explore the 
reactions of these coordinators regarding 
their recent appointments and the extent 
of their contribution to the school program. 
Findings from the study indicate the 
expressed need for greater coordination 
within the educational program in hospital 
schools of nursing. Evidence points to the 
advisability of charging one person within 
a school faculty with the primary responsi- 
bility for coordinating the educational pro- 
gram. The research data from this project 
should be assessed within the framework 
of further definitive study of the whole 
organizational pattern and allocation of the 
many functions involved in implementation 
of the educational program. 


Bell, Franc" E, A study of programs in 
selected schools of nursing to determine 
the liberal education content of the 
curriculum with specific reference to 
learning experiences related to nursing 
of the aged. London, 1966. Thesis 
(M.Sc.N.) Univ. of Western Ontario. 
This survey study explores the liberal 
education content of the curriculum of 
four purposely selected schools of nursing, 
with specific reference to learning ex- 
periences related to nursing of the aged. 
None of the schools in the sample are 
associated in the traditional manner with a 
hospital; two are located within multidisci- 
pline institutions, and two in single dis- 
cipline institutions. 
Through the use of a questionnaire, data 
were collected pertinent to the following: 
the general education prerequisite for 
entrance; what comprises the general educ- 
ation component; the means used to liber- 
alize the professional education component; 
and how these are utilized with specific 
reference to learning experiences related 
to nursing of the aged. This study is not 
intentionally either comparative or evalu- 
ative in relation to these curricula. 
Recommendations arising from the find- 
ings in the study include: 1. repetition of 
the project using a larger sample with the 
possible development of tools for purposely 
comparing and evaluating the curricula 
studied; 2. research into what comprises 
the most appropriate general education 
background for entrance into basic schools 
of nursing; 3. further exploration through 
research and the continuing refinement of 
the curricula in schools of nursing to ascer- 
tain how these may be optimally liberalized; 
4. strengthening of the general education 
and professional education preparation of 
teachers in schools of nursing to maximize 
their contribution to the liberalizing of the 
curriculum. 


MARCH 1967 



, 
". 


o 
Ie 


books 


Nursing Care of the Adolescent by S.L. 
Hammar, M.D. and Jo Ann Eddy, B.S., 
R.N. 232 pages. New York, Springer 
Publishing Company, Inc., 1966. 
Reviewed by Mrs. S. Lyons, nursing 
service supervisor, The Montreal Chil- 
dren's Hospital, Montreal, Quebec. 


This text is informative, realistic frank, 
and practical. By discussing the normal 
phases of adolescence, and by explaining and 
interpreting the confusing physical and 
emotional changes that occur, the authors 
answer many questions and clear up com- 
mon misconceptions. 
Dr. Hammar and Miss Eddy bring forth 
an important concept when they deal with 
the feelings of the nurse as well as those 
of the adolescent. They point out the need 
for the nurse to understand her own feelings 
before she can effectively cope with those 
of the adolescent and thus establish good 
rapport. 
The emotional responses and the be- 
havioral changes of the "normal" adoles- 
cent are discussed, and ways of helping 
him handle them are presented. In ad- 
dition to stating a principle to be followed, 
examples of the "how" are included, which 
make the management more concrete and 
meaningful. This is followed by a discus- 
sion of illness and the additional stress that 
this places on the teenager due to his hyper- 
sensitivity and uncertain self-image. 
Most nursing texts deal primarily with 
diseases and nursing care; however, this 
book emphasizes normal teenage growth, 
development, and behavior. The many 
unique problems confronting the sick ado- 
lescent, either physically or emotionally, 
are discussed within this context. Each 
chapter of this paperback is followed by a 
summary and suggested reference readings. 
This book would help those dealing with 
adolescents in sickness or in health, at home, 
at school, or in hospital. It simply and 
directly discusses the many and unique 
problems confronting the adolescent, and 
explains the inconsistent behavior character- 
istic of this age group, for example, resolu- 
tion of the conflict between dependency and 
independency. 
The authors' stated objective is met. "This 
book is not intended to be a comprehensive 
discourse on adolescence, for it neither 
covers the entire field of adolescence, nor 
details all illness found in this age group, 
but we hope that it will be a useful hand- 
book." 


MARCH 1967 


Continuity of Patient Care: The Role of 
Nursing edited by K. Mary Straub, R.N., 
Ed.D. and Kitty S. Parker, R.N., M.S.N. 
232 pages. Washington, The Catholic 
University of America Press, 1966. 
Reviewed by the laJe Dr. Katherine Mac- 
Laggan, director, School of Nursing, 
University of New Brunswick, Fredericton, 
N.B. 


The editors have done a yeoman job in 
their attempt to present a report of the 
1965 Workshop of the School of Nursing 
of the Catholic University of America. This 
workshop was "designed to consider the 
responsibilities of nurse practitioners in as- 
suring continuity of patient care." 
The report is presented in two parts: 
presentation of main topics, and summaries 
of seminar proceedings. The first part is 
composed of the papers presented by com- 
petent authorities, followed in some cases 
by discussions of these papers. The second 
part summarizes the discussion and the 
deliberation of the group sessions. Every- 
one familiar with the workshop technique 


DIRECTORS 
AND 
ASSIST ANT 
DIRECTORS 


tJ 

 


WORKSHOPS ON 
PROBLEM-SOLVING 


learn and practice problem- 
solving skills applied to 
Hospital Nursing Service 


Have you registered? 


Halifax April 11-14, 1967 
Vancouver May 2-5, 1967 


It s later than you think! 


Write to: 


CANADIAN 
50 The Driveway, 
Ottawa 4, Ontario. 
NURSES' ASSOCIATION 


will accept that repetItIon is unavoidable, 
and, of course, repetition is evident in this 
report. 
Details, such as demographic data, and 
legislation affecting maternal and child 
health services and mental health services, 
are American in orientation, but the inter- 
pretation of these details is applicable to 
the Canadian situation. 
All nurses, to say nothing of the power 
figures in Canada who make the big deci- 
sions about health, such as doctors, ministers 
of health, government officials, and admi- 
nistrators of health services, should read 
the report to broaden their horizons on 
the meaning of continuity of patient care. 
For instance, Dr. Eleanor P. Hunt, a 
consultant on biostatistics to the research 
division of the Children's Bureau in Wash- 
ington, says: 
"The health professions then have 
changed from their traditional role of im- 
provement of the physical ills of an indi- 
vidual on a personal basis to community 
based action leading to the prevention of 
disease and the correction of all physical, 
economic, emotional, and spiritual problems 
surrounding illness." 
While this has been said before in many 
conteAts and in other words, it still counts 
as big news for those who make decisions 
and ensure action. 
To nurse educators, the report has im- 
plications for curriculum development. To 
nurse administrators, it indicates the ex- 
tent to which the base of operation in nurs- 
ing services must be widened. To nurse 
practitioners, it provides some insight into 
the magnitude of the nursing role in con- 
temporary society. 


Gynecologic Nursing by John I. Brewer, 
M.D., Ph.D., Doris M. Molbo, R.N., 
Ph.B., and Albert B. Gerbie, M.D. 171 
pages. St. Louis, Mosby, 1966. 


The subtitle calls this "A textbook con- 
cerning nursing through an understanding 
of the patients themselves and their gyne- 
cologic problems." It is directed toward 
aiding the student to develop good judg- 
ment in patient care, rather than toward 
providing her with vast stores of facts. The 
book outlines some guides in human rela- 
tionships as well as the necessary facts and 
procedures of gynecologic nursing. 
Because the authors have prepared a 
book that will assist nurses to make judg- 
ments, much of the content involves con- 
THE CANADIAN NURSE 53 



books 


cepts that could be applied to all patients 
in hospital. Chapters on "The Essence of 
Nursing," "The Preoperative Patient," and 
'The Postoperative Patient," contain much 
material that is applicable to all surgical 
nursing, yet the approach is such that it 
is in no way repetitive. 
When the size of the book is considered. 
for it is a slim volume, one is impressed 
by the thoroughness and completeness of 
the material and the clear, concise method 
of presentation. h is an easy book to read. 
At the end of each chapter, lists of re- 
commended reading for students, patients 
and instructors are given. 
The second chapter of the book, "The 
Patient's Symptoms," presents the three 
main gynecological symptoms: bleeding, 
pruritis, and pain. This discussion of symp- 
toms, and their meaning to both patients 
and nurses, provides one of the best intro- 
ductions to patient understanding to be 
found in a nursing text. A thorough expla- 
nation of the psychological basis of symp- 
toms is supplied. The section on pain is 
excellent and should be read by every 
nurse. 
Gynecologic Nursing deserves consider- 
ation as a text in schools of nursing, and 
as well should be available on every ward 
that has gynecologic patients. It mi:;ht 
also be required reading prior to 1riservice 
discussions for graduate nurse ç . 


Maternity Care in the World, Interna- 
tional Survey of Midwifery Practice 
and Training. Report of a Joint Study 
Group of the International Federation of 
Gynaecology and Obstetrics and the In- 
ternational Confederation of Midwives. 
527 pages. 1966. Toronto, Pergamon 
Press. 
Reviewed by Miss Frances Howard, nurs- 
ing consultam, Canadian Nurses' Associa- 
tion, Ottawa, Ontario. 


Another first has been added to the in- 
creasing body of infonnation on world 
health services. Through the joint effort of 
the InternationaJ Federation of Gynaecology 
and Obstetrics and the InternationaJ Council 
of Midwives. a world survey of maternity 
health services was begun in 1961. Maternity 
Care in the World is a compilation of the 
data obtained through this survey. 
The purpose of the study was to inves- 
tigate the training and practice of midwives 
throughout the world. However the study 
group recognized the need to obtain other 
kinds of infonnation related to the practice 
of midwifery. Vital statistics on maternal 
health services as well as information on 
the training and practice of midwives was 
obtained. 
One hundred and seventy-four countries 
54 THE CANADIAN NURSE 


CNA's Repository Collection of Nursing Studies 
Next month. Canadian Library Week will be observed. Last year THE CANADIAN 
NURSE recognized a sister association's special week by a feature article on the CNA 
Library. This year it seemed appropriate to describe a rather unique aspect of the library 
service, the CNA Repository Collection of Nursing Studies. 
Four years ago the decision was made that the Canadian Nurses' Association 
would establish and maintain a collection of nursing studies. When the CNA library 
was established on a formal basis in 1964, this collection became the responsibility of 
the library. 
The collection now contains some 90 studies, and includes master's and doctoral 
theses and studies by government organizations and institutions. Their scope varies 
from major surveys of large areas or topics to investigations of relatively small scope. 
The only governing criterion is that the study is on a subject of concern to nursing in 
Canada, or, in the case of a thesis, was conducted by a Canadian nurse. 
The earliest study in the collection at present is the famous Weir Report, Survey 
of Nursing Education in Canada, printed in 1932 by the University of Toronto Press. 
This report is now out of print but is still very much in demand for schools of nursing 
libraries. This demand may now be met, in part at least, by loans from the CNA 
library. 
Recent additions to the collection include Portrait of Nursing; a Plan for the 
Education of Nurses in New Brunswick by CNA President, Dr. K.E. MacLaggan; The 
Study of Nursing Education in Canada by Dr. H.K. Mussallem for the Royal Commis- 
sion on Health Services; The Report of the Ad Hoc Committee on Nursing Education 
in Saskatchewan (Tucker Report); master's theses from some of the 1966 graduating 
class at the University of Western Ontario; and A Study of Inactive Nurses in Alberta 
by Irene M. Buchan, a Canadian Nurses' Foundation scholar, submitted toward a 
master's degree at the University of Washington. 
Canadian Nurses' Foundation scholars are required, and other master's and doctoral 
students are encouraged, to deposit their theses in the collection. Since only minimal 
funds are available to assist the students to defray typing costs of a copy of their study 
for the collection, many students prefer to lend us a copy with written permission to 
Xerox it. 
Studies deposited in the collection are shown as received in the special listings 
in the CNA Bul/etin and in the accession list of the CNA library in THE CANADIAN 
NURSE. 
In 1964, the Canadian Nurses' Association issued an Index of Canadian Nursing 
Studies (now out of print). This issue of the Index included many studies for which 
copies were not available in the collection. In the revised Index the majority of the 
studies are available for consultation from the CNA collection of Nursing Studies. 
Now, still another key to the collection will be available in the form of selected 
abstracts that are to be published periodically in THE CANADIAN NURSE. 
Use of the collection as a resource tool for nursing research and studies increases 
daily, both at national office and across Canada by inter-library loan. Some studies 
are booked months ahead. The CNA Repository Collection of Nursing Studies, while 
still young and developing, is already proving of value to the profession and to the 
contributors. 


were included in the study. Data are re- 
ported by country and by region. A com- 
mentary is included for each country. Com- 
parative tables illustrating data on maternity 
care and midwifery training and practice 
by country and by region are included. Vital 
statisticaJ data are reported for the years 
1951 and 1961. In addition there is a 
summary of the world situation. Included 
are vitaJ statistics, by region, and a sum- 
mary commentary on methods of training 
and roles and functions of midwives. Prob- 
lems of definition and registration which in- 
hibit the conduct of global studies are 
noted. 
The study group recognized that recom- 
mendations could not be made toward spe- 
cific action in individual countries. Instead, 
recommendations relate to the conduct of 
similar national studies as a prelude to the 
establishment of national P9licies. Similar 


internationaJ studies are recommended for 
the future. 
It is also recommended that aJl countries 
aim at establishing uniform definitions, thus 
allowing for more conclusive comparative 
data. Other recommendations refer to re- 
gistration of midwives, aid to developing 
countries, improvement of standards of 
training and practice. and increased country 
membership in the ICM and the F.I.G.O. 
Maternity Care in tllC World is described, 
in the preface, as "the end of the beginning," 
As such it is a vaJuable reference book for 
all health personnel involved with maternity 
services. It provides an opportunity to com- 
pare progress with that of other countries 
and to learn of other methods of training 
and utilization of midwives. The recom- 
mendations call for continued study and im- 
provement and provide a directive for future 
action, internationally and nationally. 
MARCH 1967 



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books 


Migraine by Harold Maxwell, M.D. 64 
pages. Toronto, The Macmillan Company 
of Canada Limited, 1966. 
Reviewed by Miss W. Bell, director of 
nursing service, The General and Marine 
Hospital, Owen Sound, Onto 


No. 
100 


While Migraine has been written essen- 
tially for the medical profession by one 
of its own members, this in no way detracts 
from its interest for those outside the 
profession, and particularly those afflicted 
by headache. Since we are told in the fore- 
ward that approximately one in ten of our 
adult population is affected, in some degree, 
by migraine, it should follow that this 
publication will be widely and thoughtfulIy 
read. 
Many theories are expressed as to the 
cause of migraine and it has been variously 
described throughout the centuries. Insuf- 
ficient evidence gave no real support to 
the thinking of those who sought to clas- 
sify it as an allergy. However, some evidence 
did indicate that migraine sufferers are 
more likely to be people who present 
neurotic symptoms, the most notable one 
being anxiety. It is thought that they pos- 
sess unresolved, unconscious conflicts mak- 
ing stressful life situations too difficult to 
handle. Somatic, hysterical and phobic feat- 
ures may also be observed. However, it 
must be realized that there is no conclusive 
proof that migraine is the only affliction 
to which the foregoing symptoms are 
linked. 
The doctor-patient relationship is stres- 
sed in a very positive way, and the rap- 
port and relationship between the patient 
and general practitioner is highly signifi- 
cant, being a means of lessening tension 
for the patient to a marked degree. Time, 
of course, is an essential element. 
The concluding chapter is a real high- 
light for patients with this illness. It deals 
with many of their accompanying problems 
in a most practical and helpful way and 
ends with the locations of the migraine 
clinics situated throughout England. 


No. 
169 


Medicine for Nurses, 10 ed., by W. Gordon 
Sears, M.D. (Lond.), M.R.C.P. (Lond.). 
549 pages. Toronto, The Macmillan 
Company of Canada Limited, 1966. 
Re
'iewed by Miss Thelma Pelley, director 
of nursing, Stratford General Hospital. 
Stratford, Ontario. 


This text presents a concise compilation 
of elementary data pertaining to the symp- 
tomatology, diagnosis, and medical treat- 
ment of diseases that are classified in ac- 


Next Month 
in 


The 
Canadian 
Nurse 


. Cancer 
chemotherapy 


. Changes 
in Saskatchewan's 
nursing 
education 


. Official 
opening 
of CNA 
Headquarters 


D 

 


Photo credits 


Dominion-Wide, pp. 11, 19 


National Film Board, pp. 30, 32 


National Health and Welfare, 
pp. 30, 32, 33, 43 


Miller Photo Services, Toronto, 
pp. 37, 38, 41 


University of Guelph, p. 46 


THE CANADIAN NURSE 55 



books 


cordance with their relationship to parti- 
cular body systems and/or functions. 
In the preface to this tenth edition of 
a text first published more than 30 years 
ago, the author states that he has "not 
materially altered the general plan or 
academic level of the contents." It is there- 
fore understandable that the text will 
have limited relevance to any progressive 
program in nursing. The title of the text, 
and the author's introductory comment 
that the text is designed to assist nursing 
students to acquire the minimum know- 
ledge of medical science required for the 
writing of the General Nursing Council 
examinations, suggests a simplified, in- 
complete presentation of medical data. 
In a disease-oriented approach, the text 
does not place emphasis upon any explan- 
ation of primary principles of medicine and 
their application to nursing practice. The 
limited scope of the presentation is illustrat- 
ed by the limited introductory definitions 
of "medicine" and "health," which des- 
cribe medicine as "the art and science 
of healing disease," and health as "the 
perfect structure of all organs and tissues 
of the body with a perfect performance of 
all their functions." These definitions do 


not express the broader concepts of pre- 
ventive medicine and of the World Health 
Organization definition of health which 
implies not perfection but a relative state 
of well-being and effective personal and 
social functioning. 
The format of the text is a collection of 
brief, simplified definitions organized prim- 
arily on a basis of the systems affected. 
It would seem that the format, approach, 
and content of the text tend to encourage 
memorization of given factual data rather 
than to stimulate a questioning attitude or 
an intelligent analysis and application of 
scientific principles to nursing practice. 
A further illustration of the limitations 
of the presentation is the fact that in the 
discussion of metabolism, the emphasis is 
upon disorders, with practically no refer- 
ence to the normal processes of metabolic 
function. There are brief comments upon 
fluid needs but no reference to the phy- 
siology and importance of electrolyte ba- 
lance. 


It is submitted therefore that this text 
has little to offer the instructor, student 
or practitioner of nursing who has access 
to a wide selection from many compre- 
hensive texts on pathology, physiology, and 
pharmacology. There is also a wide selec- 
tion of medical nursing texts that assist the 
nurse to understand and apply the basic 
principles of medical, physical, and social 


sciences, which are indivisibly interrelated 
to the art and science of nursing. 
All nurses today are committed to an 
obligation to be learners, teachers, and prac- 
titioners of the art of nursing. Therefore, 
the nurse of today needs the assistance of 
texts that provide intellectual stimuli and 
give an adequate illustration and explana- 
tion of the correlation and the application 
of scientific facts and principles, which are 
the underlying rationale of the essential 
skills exercised in the practice of nursing. 


Introduction to Growth, Development 
and Family Life by Dorothy Ellen Bab- 
cock, R.N., B.S.N.E., M.S.N. 2d ed. 145 
pages. Toronto, The Ryerson Press, 1966. 
Reviewed by Denise Martin, clinical in- 
structor, St. Elizabeth Hospital, Hum- 
boldt, Saskatchewan. 


This paperback text is divided into three 
parts: part one, Self Understanding; part 
two, Normal Child Development; and part 
three, Maturity. 
As stated in the preface, the book is 
intended for those engaged in Practical I 
Vocational Nursing. It is written in a very 
basic and informal style with considera- 
tion given to basic principles and the ap- 
plication of these principles to the care 
of patients. Each part is preceded by an 
overview and ended with a summary, dis- 


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THE CANADIAN NURSE 


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indigestion. And Tums are the best way 
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MARCH 1967 



books 


cussion questions, and references. Through- 
out the chapters there are many diagrams 
and illustrations. 
Part one, Self Understanding, summarizes 
the concepts of personality development 
and those factors that influence its develop- 
ment. The "iceberg" phenomenon is dia- 
gramed and explained. 
Major developmental milestones and the 
basic physical and emotional needs of the 
individual at various age levels comprise 
part two. Each chapter has a catchy head- 
ing, eg., "Jet Age - Between One and Five 
Years." The same pattern is carried through 
to part three, Maturity. 
The book fulfills the author's intention 
of preparing a book, on an introductory 
level, for the practical nurse and of doing 
this in an interesting style. 


Educational Psychology by S.R. Laycock 
and H.C. Munro. 470 pages. Toronto, 
The Copp Clark Publishing Company, 
1966. 
Reviewed by Mrs. Frederica Heasman, 
R.R. # 1, Cam , lachie Ontario. 


Writers of applied introductory texts 
face a number of hazards for they must 
try to mtroduce a subject to students who 
do not have the requisite background knowl- 
edge. Hopefully, the day will come when 
student teachers have a background of phi- 
losophy, sociology, psychology, growth and 
development, etc., before they try to for- 
mulate ideas about teaching. 
Some authors writing for students with 
limited backgrounds resort to admonish- 
ing, eg., "you must accept..... or to offer- 
ing simple solutions to complex questions, 
eg., "the best way is to..... Others offer 
much detail, obscuring the viewpoint they 
seek to express. 
A need exists for these texts and will 
continue as long as school teachers are 
being prepared in short programs in 
teachers' colleges, and nursing specialists in 
education, supervision, and public health 
are offered postgraduate courses of one 
academic year. 
This text deserves wide recognition. It 
has avoided the pitfalls and contributes 
positively to an understanding of learning. 
Some of its strengths are: I. The role of 
the teacher as outlined is warm, humane, 
and creative. Differences in students, 
teachers, and approaches to learning are 
supported, and statements made are based 
on well-chosen references. 2. A skillful selec- 
tion of the material presented has resulted 
in a well-organized text written in pleasant 
English. 3. A variety of approaches to 
problems of teaching are outlined as exam- 
ples of creative thinking rather than as 
MARCH 1967 


solutions. A basis for evaluation is sug- 
gested and is integrated throughout the text 
in such a way that evaluation is presented 
as one process of learning. 4. It would 
be difficult for a person using this text to 
avoid going on to further reading in the 
areas considered as the approach is broad 
and the references are well used. 
This text would be of value for beginning 
teachers in nursing schools and for public 
and occupational health nurses. It could 
also help the experienced teacher who is 
feeling "dried up" or discouraged. 
It is a pleasant experience to read this 
book. The authors' sincerity, enthusiasm, 
and respect for learners remains undiminish- 
ed after a lifetime of teaching. 


The Nursing Clinics of North America, 
vol. I, no. 3, September 1966. June S. 
Rothberg, guest editor. Chronic Disease 
and Rehabilitation. 533 pages. A W.B. 
Saunders publication, available in Canada 
from McAinsh & Co. Ltd., of Toronto 
and Vancouver. 
Reviewed by Mrs. J. Peitchinis, associate 
professor, School of Nursing, University 
of Western Ontario, London, Ontario. 


Twenty nursing specialists contribute 17 
papers to this "Symposium on Chronic 
Disease and Rehabilitation," which prob- 
ably does provide, as the guest editor hoped 
it would, valuable new insight and specific 
suggestions for nurses practicing in all set- 
tings. 
The reviewer concurs with those authors 
who perceive many of the assumptions 
and practices discussed in the symposium 
to be applicable and imperative in all nur- 
sing: there are rehabilitative aspects in the 
care of most patients, and one looks 
forward to the time when all nursing 
practice is directed toward them, so that 
the adjective rehabilitative becomes un- 
necessary. The reviewer prefers the term 
long-term illness or disability employed by 
many of the contributors to those of chronic 
disease or disability used in the subtitle, 
and by some of the authors. 
The symposium sets out many of the 
basic assumptions underlying "rehabilitative 
nursing." It discusses the assessment of 
"patient need," approaches to working ef- 
fectively with patients, and means for co- 
ordinating all the services of the health 
team. In some papers the nurse is seen as 
the team leader. The role of the clinical 
nursing specialist in a rehabilitation center 
is described, and possibilities for nursing in 
industrial health settings are suggested. Not 
only is consideration given to the care of 
patients with particular long-term illnesses, 
but also to the process of aging, and to re- 
habilitation of psychiatric and pediatric 
patients. There are numerous illustrations 
and patient studies to facilitate the reader's 
understanding; proposals for teaching re- 
habilitative care to nonprofessional person- 
nel are also presented. 


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THE CANADIAN NURSE 57 



films 


Fire Safety 
They Called It Fireproof was produced 
in 1963 by the National Film Board. In the 
film, a coroner's inquest investigates the 
causes of a fire that took the lives of 
two patients in a supposedly "fireproof' 
hospital. It shows how every individual in 
the hospital has a responsibility for safety- 
consciousness and constant vigilance. 
The film is an excellent one for all levels 


, rJæt. 


, 



'" 


.. 


of hospital personnel, and should be shown 
in all schools of nursing and be used ex- 
tensively in inservice education programs. 
The 28-minll1e, color, sound picture re- 
ceived an award from the (USA) National 
Committee on Films for Safety. It is avail- 
able on loan for a nominal service charge 
from the regional office of the National 
Film Board, or from the Canadian Film 
Institute. 1762 Carling Ave.. Ottawa 13. 


Community Health 
A useful film for student nurses learning 
about community and public health pro- 
grams might be A Day in the life of a 


, 


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general feeling of well-being. It lets you walk on the entire 
bottom of your foot instead of Just the heel and ball. This 
allows you to walk and stand longer without strain. 
For the name of your nearest Air Step dealer, write Air Step WARD 
DivisIOn, Brown Shoe Company of Canada, Ltd., Perth, $15.99 
o.l""'


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THE SHOE WITH THE MAGIC SOLE 'Prices quoted are Suggested Retail Prices. 
Air Step Division, Brown Shoe Company of Canada Ltd., Perth, Ontario 
58 THE CANADIAN NURSE 


MEDIC 
$15.99* 


Public Health Nurse. This film was prepar- 
ed for television audiences and centers 
around the South Okanagan Health Unit in 
Kelowna, B.C. It shows some of tl}e special 
services offered in the health department. 
It also illustrates some of the facilities 
for consultation and service from the staff 
of the provincial mental health services. 
The film can be obtained from the Cana- 
dian Film Institute, 1762 Carling Ave., 
Ottawa 13, or from your provincial film 
library. The black and white film was 
produced in : 963 and runs for 12 minutes. 


accession list 


Publications in this list of material 
received recently in the CNA library are 
shown in language of source. The majority 
(reference material and theses, indicated 
by R excepted) may be borrowed by CNA 
members, and by libraries of hospitals and 
schools of nursing and other institutions. 
Requests for loans should be made on the 
"Request Form for Accession List" {page 
60) and should be addressed to: The 
Library, Canadian Nurses' Association, 
50 The Driveway, Ottawa 4, Ontario. 


BOOKS AND DOCUMENTS 
I. Australasian hospital directory and 
nurses' year book 1966. Compiled and an- 
notated by A.L. Hart. Sydney, N.S.W., 
New South Wales Nurses' Assoc., 1966. 
185p. R 
2. Canadian annual review, 1965. Edit- 
ed by John Saywell. Toronto, University 
of Toronto Press, 1966. 569p. R 
3. Child psychiatry. Ottawa, Canadian 
Psychiatric Association Journal, vol. 10, 
no. 5, October 1965. p. 423-443. 
4. Comparisons of intensive nursing 
service in a circular and a rectangular unit; 
Rochester Methodist Hospital, Rochester 
Minn., by Madelyne Sturdavant. Chicago. 
American Hospital Association, 1960. 
219p. 
5. Examinations and their place ill med- 
ical education and educational research. 
Edited by John P. Hubbard. Evanston Ill., 
Association of American Medical Colleges, 
c1966. 69p. (Journal of Medical Education. 
vol. 41, no. 7, pt. 2, July 1966.) 
6. Factors influencing continuity of 
nursing service by Louise C. Smith. Study 
sponsored by National League for Nursing; 
directed by Institute of Research and Ser- 
vice in Nursing Education, Teachers Col- 
lege, Columbia University. New York, 
NLN, 1962. 139p. 
7. Handbook for the night super- 
visor in the small hospital by Sister M. 
Virginia Clare. St. Louis. Catholic Hospital 
Association, 1963. lOOp. 
8. Higher education ill a changing 
Canada; symposium presented by Royal 
MARCH 1967 



accession list 


Society of Canada in 1965. Edited by J.E. 
Hodgetts. Toronto, Published for the 
Society by University of Toronto Press, 
1966. 90p. 
9. Horizons unlimited; a handbook des- 
cribing rewarding career opportunities in 
medicine and allied fields. Chicago, Amer- 
ican Medical Association, c1966. l30p. 
10. How to find ollt; a guide to sources 
of information for all arranged by the 
Dewey Decimal Classification. Edited by 
G. Chandler. 2d ed. London, Pergamon, 
c1963. 198p. 
I I. Manual of hospital planning pro- 
cedures. Chicago, American Hospital As- 
sociation, 1966, cl958. 72p. 
12. The nursing clinics of North Amer- 
ica, v. I, no. 4. December, 1966. Philadel- 
phia, Saunders. 209p. Contents: Sympo- 
sium on the nurse and the new machinery. 
Ruby M. Harris, guest editor. Symposium 
on mental retardation, Kathryn Barnard, 
guest editor. 
13. Occasional paper ':0. 64, Ottawa, 
Canadian Library Association, 1966. 2 pts. 
pt. I. Canadian books, pamphlets and do- 
cuments on gerontology in the Library of 
Parliament. pt. 2. Articles on aging indexed 
in Canadian periodical index 1947-1965, 
excerpted by Joan O'Rourke. 
14. The operation of state hospital 
planning and licensing programs by G. Hil- 
ary Fry. Chicago, American Hospital As- 
sociation, c1965. l34p. 
15. Personal and vocational relation- 
ships of the practical nurse by Marion 
Keith Stevens. Philadelphia, Saunders, 1967. 
258p. 
16. Pharmacology for practical nurses 
2d. ed. by Mary Kaye Asperheim. Philadel- 
phia, Saunders, 1967. 163p. 
17. The Planning of change; readings 
in the applied behavioral sciences edited 
by Warren G. Bennis and Kenneth D. 
Benne and Robert Chin. New York, Holt, 
Rinehart and Winston, 1964, c1961. 289p. 
18. Psychology of human behavior for 
nurses, 3d ed. Lorraine Bradt Dennis. Phi- 
ladelphia, Saunders, 1967. 289p. 
19. Psychology of human behavior for 
nurses, 3d ed. Instructors' guide, by Lor- 
raine Bradt Dennis. Philadelphia, Saunders, 
1967. HOp. 
20. The sister as a clinical specialist by 
Sister Léon Douville and Sister Marilyn 
Emminger. St. Louis, Conference of Catho- 
lic Schools of Nursing, 1966. 126p. 
21. Skills that build executive success. 
Boston, Graduate School of Business Ad- 
ministration Harvard University, 1964. 
121p. (Selections from Harvard Business 
Review.) 
22. A sociological framework for patient 
care. Edited by Jeannette R. Folta and Edith 


MARCH 1967 


S. Deck New York, Wiley, c1966. 418p. 
23. A study of arbitration decisions by 
Carl Hamilton. Toronto, United Steel- 
workers of America, 1966. 84p. 
24. Your health and you by H.P. 
Simonson and E.A. Hastie and H.A. 
Dorothy. Toronto, Macmillan, c1966. 
153p. 


PAMPHLETS 
25. A brief to Committee on the Heal- 
ing Arts. Toronto, Registered Nurses' As- 
sociation of Ontario. 1966. 27p. 
26. Enrolment in Canadian universities 


anå colleges to 1976/77; 1966 projection, 
by Edward F. Sheffield. Ottawa, Associa- 
tion of Universities and Colleges, 1966. 
20p. 
27. An index of care by J.A.K. Mac- 
Donell and G.B. Murr!!y, Ottawa, Medical 
Services J. 31 :499-517, Sep. 1965. Reprint. 
28. Job descriptions. St. John's, Asso- 
ciation of Registered Nurses of Newfound- 
land, 1966. 16p. 


29. Joint statement on non-nursing acti- 
,'ities carried out by nursing personnel in 
some hospitals. Vancouver, British Colum- 
bia Hospitals' Association and Registered 


DANDRUFF 
WARD 


DANDRUFF 
WARD 



 


You won't see this in your hospital 


We're not trying to fool you. 
We're making a point' 
That dandruff is a serious medical 
problem and the only truly effective 
treatment is the medical one - Selsun 
by Abbott. 
Selsun clears up annoying, unsight- 
ly dandruff in two or three treatments. 
(thoroughly effective in 92% to 95% 
cases reported l ). 
You use it like any shampoo. Works 
fast. Comes in a handy unbreakable 
bottle. Leaves your hair glistening. 


Really, there's no room for dandruff 
in your professional or social life. Use 
Selsun and get to the root of the 
problem. 
Precautions: Occasional sensitization 
of the neck and external ear may 
occur. Falling hair which may accom- 
pany scalp treatment is usually due to 
an impoverished or diseased condition 
of the hair and scalp. 
1 Slinger, W. N., and Hubbard, D. M., Treat- 
ment of Seborrheic Dermal,tis with a Shampoo 
Containing Selenium Disulfide, Arch. Dermal. 
& Syph.. 64:41, 1951. 


EJ 


Selsun* 


.Trademark registered 


(Selenium Sulfide Detergent Suspension, U.S.P.) 
ABBOTT LABORATORIES LIMITED Halifax. Montreal. Toronto. Winnipeg' Vancouver 
THE CANADIAN NURSE 59 



accession list 


Nurses' Association of Britis!l. Columbia 
Joint Committee, 1966. 6p. 
30. A list of schools of nursing in 
Olltario and minimum education require- 
ments for entrance. Toronto, Ontario Hos- 
pital Association, 1966. 30p. 
31. Problem areas in the scientific, 
engineering and nursing professions by 
Garnet T. Page. Montreal 1963. 9p. 
32. Sun'ey of salaries and employment 
conditions in non federal psychiatric hos- 
pitals. June 1, 1965. New York, American 
Nurses' Association. Research and Statistics 
Unit, 1966. 31p. 
33. Tentative draft for 1966-67 of the 
policies and procedures of accreditation of 
the Dept. of Baccalaureate and Higher 
Degree Programs of the National League 
for Nur
im!. rev. New York. National 
League for Nursing. Dept. of Baccalaureate 
and Higher Degree Programs, 1966. 20p. 
34. Théorie et pratique du case work 
par Gordon Hamilton. Paris, Comité fran- 
çais de service social et d'action sociale, 
1965. 294p. 
35. To make a good assignment by 
Laura Jean Otto New York, National 
League for Nursing. Dept. of Hospital 
Nursing, 1963. 21p. 


GOVERNMENT DoCUMENTS 
Canada 
36. Bureau fédéral de la statlstlque. 
Annuaire du Canada; ressources, histoire, 
institutions et situation économique et so- 
ciale du Canada. Ottawa, Imprimeur de la 
Reine, 1966. 1302p. 
37. Dept. of Labour. Legislation 
Branch. Developments in the enactment 
and administration of labour laws in Cana- 
da; August, 1 965-September, 1966. Ottawa, 
1966. 67p. 
38. Dept. of National Health and Wel- 
fare. Emergency Health Services. Emer- 
gency hospital operating manual 1966. Ot- 
tawa, Queen's Printer, 1966. 102p. 
39. Ministère de la Santé Nationale et 
du Bien-être Social. Services de Santé 
d'Urgence. La section du nursing. Biblio- 
graphie se rapportant au nursing d'urgence. 
Ottawa, 1965. 30p. 
40. Ministère de la Santé Nationale et 
dll Bien-être Social. Services de Santé d'Ur- 
gence. Soins médicaux en cas de désastre; 
collection d'artic1es. Ottawa, 1965. 135p. 


Nova Scotia 
41. Dept. of Labour. Economics and 
Research Division. Wage rates and hours 
of labour in Nova Scotia. Halifax, 1966. 
226p. 


United States 
42. Dept. of Health, Education and 


Welfare. Public Health Service. Admini- 
strative aspects of hospital central medical 
and surgical supply sen'ices. Washington, 
1966. 37p. 
43. -. A manual for hospital cen- 
tral medical and surgical supply services. 
Washington, 1966. 106p. 
44. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree- 
ments; arbitration procedures. Washington, 
U.S. Govt. Print. Off., 1966. 167p. 
45. -. Major collective bargaining 
agreements; management rights and union- 
management co-operation. Washington, 
U.S. Govt. Print. Off., 1966. 69p. 
46. National Center for Health Statistics. 
Report of the United States delegation to 
the 1nternational Conference for the Eighth 
Revision of the International Classification 
of Diseases. Geneva, July 6-12, 1965. 
Washington, U.S. Govt. Print. Off, 1966. 


STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECfION 
47. Senior nursing students career plans 
and their knowledge of and preparation for 
selected positions in nursing by Sister Loret- 
ta Morin. Washington, 1966. Thesis 
(M.Sc.N.) Catholic University of Amer- 
ica. 62p. R 
48. Survey of schools of nursing in the 
province of Nova Scotia compiled by Sister 
Clare Marie. Halifax, Registered Nurses' 
Association of Nova Scotia, 1966. 2Op. R 


Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 


Send to: 
LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. 
Please lend me the following publications, listed in the . .... _. .. __ .... ..._ 
Canadian Nurse, or add my name to the waiting list to receive them when available: 


Item 
No. 


Author 


issue of The 


Short title (for identification) 


Requests for loans will be filled in order of receipt. 
Reference and restricted material must be used in the CNA library. 
Borrower 
Position 
Address 
Date requested .. 


60 THE CANADIAN NURSE 


MARCH 1967 



classified advertisements 


ALBERTA 


NIGHT SUPERVISOR, R.N. AND MEDICAL HEAD 
NURSE for 9O-bed active treatment hospital in the 
City of Wetoskiwin, situated midway between Ed- 
monton and Red Deer. Residence accommodation 
available, excellent salary ranges and fringe benefits 
in effect, as well as payment for prior experienc:e. 
Apply to: Director of Nursing, Municipal Hospitol, 
Wetaskiwin, Alberto. 1-96-1 
Registered Nurs.. (5) required (summer relief or per- 
manent posts) for May 1967. The Peace River Municipal 
Hospital, Alberto, was built 5 years ago and has a 
complement of 70 beds. Starting salary for J 966 
$370. New salary scoles expected for 1967. Peace 
River is a progressive town and a beauty spot on the 
Prairies. Apply to: The Director of Nursing for fuller 
particulars. Peace River Municipal Hospital, Peace 
River, Alberto. 1.69-1 
REGISTERED NURSES FOR GENERAL DUTY (WANTED) 
for a 37-bed Generol Hospital. Solory $380. $440 
per month. Commencing with $375 with 1 year and 
$390 with 3 years practical experience elsewhere. 
Full maintenance available at $35 per month. Pen- 
sion plan available, train fare from any point in 
Canada will be refunded after I year employment. 
Hospital located in a town of 1,100 population, 85 
miles from Capitol City on a paved highway. 
Apply to: Two Hills Municipal Hospital, Two Hills, 
Alberto. 1.88.1 
NURSES FOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hot. 
Nurses on stoff must be willing and able to toke reo 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses' residence with all lingle rooms situated On 
hospital grounds. Apply to: Mrs. M. Hislop, Adminis- 
trator and Director of Nursing, Bassano General Hos- 
pital, Bossano, Alberto. 1.5.1 


ADVERTISING 
RATES 


FOR ALL 
CLASSIFIED ADVERTISINC 


$10.00 for 6 Ii nes or less 
$2.00 for each additional line 


Rates for display 
advertisements on request 


Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 
The Canadian Nurses' Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses' Association of the 
Province in which they are interested 
in working. 


Address correspondence to: 


The 
Canadian 
Nurse 


D _ 

 


50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 


MARCH 1967 


I I 


ALBERTA 


General Duty Nur.e. for active, accredited, well- 
equipped 64-bed hospital in growing town, population 
3,500. Salaries range from $380-$440 COmmensurate 
with experience, other benefits. Nurses residence. 
Excellent personnel policies and working conditions. 
New modern wing opened this year. Good COmmu- 
nications to large nearby cities. Apply Director of 
Nursing, Brooks General Hospital, Brooks, Alberto. 
1-13-18 


GENERAL DUTY NURSES for modern 25-bed hos- 
pital on Highway No. 12, East-Central Alberto. 
Salary range $380 to $440. (including a regional 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronotion Municipal Hospital, 
Coronation, Alberto. Tel.: 578-3803. 1-25-18 
GENERAL DUTY NURSES for 64-bed, active treatment 
hospital, 35 miles South of Calgary. Salary range 
$360 - $420. living accommodation avoiloble in 
separate residence if desired. Full maintenance in 
residence $35 per month. 30 days paid vocation after 
12 months employment. Please appl y to: The Director 
of Nursing, High River Municipa Hospital, High 
River, Alberto. 1.46.1 


GENERAL DUTY NURSES: Madern 26-bed hospital 
close to Edmonton. 3 buses doily. Salary $360.00 to 
$420.00 per month commensurate with experience. 
Residence available $35.00 per month. Excellent 
personnel policies. Apply: Director of Nursing, 
Mayerthorpe Municipal Hospital, Mayerthorpe, Al- 
berto. 1-61.1 


GENERAL DUTY NURSES for 94-bed General Hospitol 
located in Alberto's unique Dinosaur Badlands. $360 
- $420 per month, 40 hour week, 31 days vocation, 
pension, Blue Cross, M.S.1. and generous sick time. 
Apply to: Miss M. Howkes, Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberto. 1-31-2 A 


BRITISH COLUMBIA 


Operating Room Head Nune ($464 - $552), General 
Duty Nurses (B.C. Registered $405 - $481, non-Regis- 
tered $390) for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, c"rling 
and bowling. Hot springs swimming nearby. Nurses' 
residence, rOOm $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36.1 
Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Registered Nurses (or those eligible) to apply for 
positions in Medicine Surgery and Psychiatry. Apply 
to: Director of Nursing. Victoria, British Columbia. 
2-76-4A 


A Medical-Surgical Nursing Instructor, with University 
preparation, for a 450-bed hospital with a school of 
nursing, 150 students. Apply: Sister Mary Ronalda, 
M.N., Director, School of Nursing, St. Joseph's Hos- 
pital, Victoria, B.C. 2-76-5B 
PSYCHIATRIC CLINICAL INSTRUCTOR required by 
ROYAL INLAND HOSPITAL, KAMLOOPS, British Col- 
umbia. For further information write to: Director of 
Nursing Education, Royal I nland Hospital, Kam- 
loops, B.C. 2-81-2 


REGISTERED, GRADUATE NURSES AND PRACTICAL 
NURSES for modern 70-bed accredited hospital On 
Vancouver Island, B. C. Resort area - home of the 
tyee salmon - four hours travelling time to City of 
Vancouver. RNABC policies and Union Contract in 
effect. Residence accommodation available. Direct 
enquiries to: Director of Nursing, Campbell River and 
District General Hospital, Campbell River, British 
Columbia. 2-9-1 A 


Graduate Nur.H of Christian conviction: (Urgently 
wanted). Willing to serve for one year or more in 
Mission Hospitals in the outlaying areas of Canado. 
Immediate need at Queen Charlotte Islands, Bello 
Bello, Hazelton and Burns Lake in British Columbia 
and at Boie Verte, in Newfoundland. Salary and 
working conditions as agreed between Reg. Nurses' 
Association and Hospital Association of Province con- 
cerned. Please contact: Board of Home Missions of 
The United Church of Canada, 85 St. Clair Ave., E., 
Toronto 7, Ontario, or Dr. W.D. Watt, 6762 Cypress 
Street, Vancouver 14, B.C. 2-73-25 


GRADUATE NURSES for 24-bed hospital, 35-mi. from 
Vancouver, on coast, lalary and personnel prac. 
tices in accord with RNABC. Accommodation availa- 
ble. Apply: Director of Nursing, General Hospital, 
Squamish, British Columbia. 2-68-1 


I I 


BRITISH COLUMBIA 


B.C. R.N. for General Duty in 32 bed General Hospi. 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefit., modern, comfortable, nurses' residence in 
ottroctive community clole to Vancouver, B.C. For 
application form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. I, Hope, B.C. 2.30-1 
GENERAL DUTY NURSES (Two) for active 66-bed 
hospital, with new hospital to open in 1968. 
Active in-service programme. Salary range $372 to 
$444 per month. Personnel pol icies according to 
current RNABC contract. Hospital situated in beauti- 
ful Eost Kootenoys of British Columbia, with swim- 
ming, golfing and skiing facilities readily available. 
Apply to: The Director of Nursing, St. Eugene Hos- 
pital, Cranbrook, British Columbia. 2-15-1 
General Duty NurSH for active 30.bed hospital. 
RNABC pol icies and schedules in effect, also North- 
ern allowance. Accommodations available in res. 
idence. Apply: Director of Nursing, General HOlpital, 
Fort Nelson, British Columbia. 2.23.1 
General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in accordance with RNABC. Com- 
fortable Nurses' home. Apply: Director of Nursing, 
Boundary Hospital, Grand Forks, British Columbia. 
2.27-2 


General Duty -Nurle. (2 immediately) for active, 
26-bed hospital in the heart of the Rocky Mountains, 
90 miles from Bonff and Lake Louise. Accommoda- 
tion available in attractive nurses' residence. Apply 
giving full details of training, experience, etc. to; 
Administrator, Windermere District Hospital, Inver- 
mere, British Columbia. 2.31-t 
General Duty Nunes for new 37-bed hospital. 
Located in Southwest British Columbia. Salary and 
personnel pol icies in accordance with RNABC. $390 
to $466. Accommodation available in residence. Apply 
to: Director of Nursing, Nicolo Volley General Hos- 
pital, Box 129, Merritt, British Columbia. 2-41-t 


General Duty Nurses for well-equipped 80-bed Gener- 
al Hospital in beautiful inland Volley adjacent Lake 
I{athlyn and Hudson Boy Glacier. Initial salary $387. 
Maintenance $60, 40-hour 5 day week, vacation with 
pay, comfortable, attractive nurses' residence, 
Boating, fishing, .wimming, golfing, curling, skating, 
skiing. Apply to: Director of Nursing, Bulkley Volley 
District Hospital, P.O. Box No. 370. Smithers, British 
Columbia. 2-67-1 


GENERAL DUTY NURSES - Salary - non - B.C. 
registered $375 per month - B.C. registered $390- 
$466, depending On experience. RNABC policies in 
effect. Nurses' residence avai'able. Group Medicol 
Health Plan. All winter and summer sports. Apply: 
Director of Nursing, Cariboo Memorial Hospital, Wil- 
I iams Lake, British Columbia. 2-80-1 A 
General Duty O. R. and experienced Obstetrical 
Nunes for modern, 150-bed hospital located in the 
beautiful Fraser Valley. Personnel policies in ac- 
cordance with RNABC. Apply to: Director of Nursing, 
Chilliwack General Hospitol, Chilliwack, British Co- 
lumbia. 2-13-1 


General Duty and Operating Room Nurses for 70.bed 
Acute General Hospital on Pacific Coast. B.C. Regis- 
tered $390 - $466 per month (Credit for experience). 
NOn B.C. Registered $375 - Practical Nurses B.C. Li- 
censed $273 - $311 per month. Non Registered $253. 
$286 per month. Boord $20 per month, room $5.00 per 
month. 20 paid holidays per year and to statutory 
holidays after 1 year. Fare paid from Vancouver. 
Superannuation and medical plans. Apply: Director of 
Nursing, St. George's Hospital, Alert Boy, British 
Columbia. 2-2.t A 


Genera. Duty, Operating Room and Experienced 
Obstetrical Nunes for 434-bed hospital with schoo' 
of nursing. Salary: $372-$444. Credit for post ex. 
perienc8 and postgraduate troining. 40-hr. wk. Stat 
utory hol idays. Annual increments; cumulative sick 
leave; pension plan. 28-daYI annual vacation; B.C. 
registration required. Apply: Director of Nursing, 
Royal Columbian Hospital, New Westminster, British 
Columbia. 2-73./3 
GENERAL DUTY NURSES - for t09.bed hospital in 
expanding Northwestern British Columbia City. Salary 
$405 to $481 for B.C. Registered Nurses with recogni- 
tion for experience. RNABC contract in effect. Gradu- 
ate Nurses not registered in B.C. paid $390. Benefits 
include comprehensive medical and pension plans. 
Travel allowance up to $60 refunded after One 
year's service. Comfortable modern residence accom- 
modation at $ J 5 per month, meals at cost. Apply to, 
Director of Nursing, Prince Rupert General Hospital, 
551.5th Avenue East, Prince Rupert, B.C. 2-58-2A 
THE CANADIAN NURSE 61 



BRITISH COLUMBIA 


General Duty ønd Operating Room Nurses for 
modern 450-bed hospitol with School of Nursing. 
RNABC policies in effect. Credit for past experience 
and postgraduate training. British Columbia registra.: 
tion required. For particulars write to: the Director of 
Nursing Service, St. Joseph's Hospital, Victoria, British 
Columbio. 2.76-5 


Graduate Nurse required for 26-bed hospital in sunny 
B.C. interior, solory $410 per month with 28 doys 
annual vacation plus 10 paid stats. Full room and 
board in TV equipped residence $50 per month with 
free uniform loundry. Apply: Director of Nursing, 
Princeton General Hospital, Princeton, B.C. 2-59-1 


GRADUATE NURSES: Join uS at the booming center 
of B.C.I! Surrounded by 50 beautiful lakes with 
excellent boating, swimming, fishing plus all winter 
sports. On hour's drive from Prince George, the 
fastest growing city in Canada. Active 44-bed hos- 
pital and modern nurses' residence over looking the 
picturesque Nechako River. Starting salary $372 - $408, 
recognition given for experience. Health and pension 
plan, 40-hr. week and 4 weeks \lacotion. Write to: 
Mrs. M. Grant, Director of Nursing, St. John Hospital, 
Vanderhoof, British Columbia. 2-74-1 


Graduat. Nun.. for G.n.ral Duty in modern 188- 
bed hospital in city (20,000) on Vancouver Island. 
Personnel policies in accordance with RNABC poli- 
cies. Starting salary for R.N. $372. per month. Apply 
to: Director of Nursing, Regional General Hospital, 
Nanaimo, British Columbia. 2-46-1 


MANITOBA 


Dir.ctor of Nun.. for up-to-date 38-bed hospital. 
New nurses' residence of 1964 has separate nursel 
suite available. Sick leave, pension plan and other 
fringe benefits available. Personnel policies will be 
lent on request. Enquiries should include experience. 
quaHfkations and salary expected, and should be 
addressed to: Mr. O. Hamm, Administrator, Alfona 
Ho.pital District No. 24, Box 660, Altona, Manitoba. 
3-1-1 


Register.d Nurse: Required for 50-bed general hospital 
in fort Churchill, Manitoba. Starting salary $500 per 
month. Return fare from Winnipeg refunded after one 
year.s service. For particulars write to: Director of 
Nursing, General Hospital, fort Churchill, Manifoba. 
3-75-1 


R.gi.t.r.d Nur..' for I B-bed hospital at Vita Manitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
rang. $380 - $440, with allowanc. for experi.nc.. 
40 hour week, 10 statutory holidays, 4 weeks paid 
vacation after one year. Full maintenance available 
for $50 per month. Apply: Matron, Vita District 
Hospital, Vita, Manitoba. 3-66-1 


Registered Nurses and Licensed Practical Nurses for 
232-bed Children's Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: Director of Nursing, Children's Hos- 
pital, Winnipeg 3, Manitoba. 3-72-1 


Regist.r.d Nurs. for G.neral Duty in 20-bed hospital. 
Solary range $405 - $490 per month. Living accom- 
modations available. Generous personnel pol icies. 
Apply: Director of Nurs
ng, Reston Community Hos- 
pital. Reston, Man. 3-46-2 


G.n.ral Duty Nurse. for 100-bed active treatment hos- 
pital. fully accredited. 50 miles from Winnipeg on 
Trans Canada Highway. Apply: Director of Nursing 
Service. Portage District General Hospital. Portage La 
Prairie, Manitoba. 3-45-1 


NOVA SCOTIA 


Director for School of Nur.ing: 50 students. Excellent 
working conditions. Apply to: M. Jean Hemsworth, 
Administrator, Glace Bay General Hospital, Glace 
Bay, Nova Scotia. 6-15.1 


R.gi.ter.d and Groduat. Nur... for G.n.ral Duty. 
New hospital with all modern conveniences, also. 
new nurses' residence available. South Shore Com. 
munity. Apply to: Superintendant. Queens General 
Hospital, Liv.rpool, Nova 5cotia. 6-20-1 


R.gi.t.r.d Nur... for 21-bed hospital In pleasant 
community - Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital, 
Sheet Harbour, Nova Scotia. 6-32-1 


62 THE CANADIAN NURSE 


I I 


ONTARIO 


Co..ordinator of Clinic.al Nursing Studies in the 
Bachelor of Scienc:e in Nursing Course: The School 
of Nursing, McMaster University. invites applications 
from persons with advanced qualifications in clinical 
nursing. The position is open for the 1967- J 968 
session. with duties commencing July 1967. Please 
apply sending curriculum vitae and two references 
to: Director, School of Nursing, McMaster University, 
Hamilton, Ontario. 7-55-15 


REGISTERED NURSES (IMMEDIATELY) for a new 40- 
bed hospital. Nurses' residence - private rooms with 
bath - $20 per month. Minimum salary $415 plus 
experience allowance, 4 semi-annual increments. 
Reply to: The Director of Nursing, Geraldton District 
Hospital, Geraldton, Ontario. 7.50-1 A 


Algonquin Park cømp for girl.: R.quires R.gi.ter.d 
Nur.... July and/or August. Single, under 50. Apply: 
Camp Tanamakoon, 24 Wilberton Road, Toronto 7, 
Ontario. HU. 1-3704. 7-133-72 


Registered Nurses and Registered Nursing Assistants 
are invited to make appl ication to our 75-bed. 
modern General Hospital. You will be in the Vaca- 
tionland of the North, midway between the Lakehead 
and Winnipeg, Manitoba. Bosic wage for Registered 
Nurses is $408 and for Registered Nursing Assistants 
is $285 with yearly increments and consideration for 
experience. Write or phone: The Director of Nursing. 
Dryden District General Hospital, DRYDEN, Ontario. 
7-26.1 A 


Registered Nurses and Registered Nursing Assistant. 
for 83-bed General Hospital in french speaking cOm- 
munity of Northern Ontario. R.N.'s salary: $420 to 
$465/m., 4 weeks vacation, 1 B sick leave days and 
R.N.A.'s salary: $300 to $340/m., 2 weeks vacation 
and 12 sick leav. days. Unused sick leave are paid 
at 100 0/0. Rooming accommodations available in 
Town and meals served at the Hospitol. Excellent 
personnel policies. Apply to: Director of Nursing, 
Notre-Dame Hospital, Hearst, Ontario. 7.58-1 


Regiltered Nurses and Registered Nursing Allistants. 
Starting Salary for R.N. is $415 and for R.N.A. i. $300. 
Allowance for experience. Exc.llent fringe benefits. 
Write: Mrs G. Gordon, Superintendent, Nipigon Dis- 
trict Memorial Hospital, Box 37, Nipigon, Ontario. 
7-87-1 


Registered Nurse. and Registered Nuning Aisistønts 
for 160-bed accredited hospital. Starting salary $415 
and $285 respectively with regular annual incre- 
ments for both. Excellent personn.1 policies. Resid- 
ence accommodation available. Apply to: Director of 
Nursing, Kirkland & District Hospital, Kirkland Lake, 
Ontario. 7-67.1 


Registered Nurses and Registered Nursing Alsistants 
for 123-bed accredited hospital. Starting salary $400 
and $255 respectively with regular increments for 
both. Usual fringe benefits. for full information, 
apply to: Director of Nursing, Dufferin Area Hos- 
pital, Orongeville, Ontario. Phon. 941-2410. 7-90-1 


Registered Nurses and Registered Nursing Assistants: 
Applications are invited from R. N's and R. N. Ass'ts. 
who are interested in returning to "nursing at the 
bedside" in a well-equipped General Hospital. Excel- 
lent starting salaries and fringe benefits now. Further 
increase January 1. 1967. Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux Lookout General Hospital, P. O. Box 
909, Sioux Lookout, Ontario. 7-119-1 A 


Regi.t.red Nun.. for 34-bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462. 3-wk. vacation with pay; sick leave after 
6-mo. servic.. All Staff - 5 day 40-hr. wk.. 9 
statutary holidays, pension plan and other b.nefits. 
Apply to: Superint.ndent, Englehart & District Hos- 
pital, Engl.hart, Ontario. 7-40.1 


Registered Nurse.. Applications and enqulfles are 
invited for general duty positions on the staff of th. 
Manitouwadge General Hospital. Exc.lI.nt salary 
and fringe benefits. Liberal policies regarding ac- 
commodation and vacation. Modern well-equipped 
33-bed ho
pital in new mining town, about 250.mi. 
east of Port Arthur and north-west of White River, 
Ontario Pop. 3.500. Nurses' residence comprises indi- 
vidual self-contained apts. Apply, stating qual ifica- 
tions., experience, age. marital status, phone number. 
etc. to the Administrator. General Hospital, Mani- 
touwadge, Ontario. phone 826-3251 7-74-1 A 


Registered Nurses: Applications are invited for Gener- 
al Duty Staff Nurses; Gross salary range: $362 to 
$422. Supervisory advancement opportunities. Resident 
accommodations available; Hospital situated in tourist 
town off Lake Huron. For further information write: 
Superintendent, Sougeen Memoríal Hospital, South- 
ampton, Ontario. 7-122-1 


I I 


I I 


ONTARIO 


PUBLIC HEALTH NURSES: B.C. Civil Service. Salary: 
$476-$580 per monfh, car provided. Interesting and 
challenging professional service with opportunities for 
transfer throughout beaufiful B.C. Apply to: B.C. 
Civil Service Commission, 544 Michig